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p  AN  IIMSIGHT  BOOK  BY  VAIM  IMOSTRaM 


the  CRISIS  in  PSYCHIATRY 
fq%l\         and  RELIGION 

by  OJHOBART  MOWRER 


UNIVERSITY 
OF  FLORIDA 
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in  2010  with  funding  from 

Lyrasis  IVIembers  and  Sloan  Foundation 


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THE  CRISIS  IN 
PSYCHIATRY  AND  RELIGION 


by 

O.  HOBART  MOWRER 

University  of  Illinois 


m  INSIGHT  BOOK 


D.  VAN  NOSTRAND  COMPANY,  INC. 

PRINCETON,  NEW  JERSEY 

TORONTO  LONDON 

NEW  YORK 


D.  VAN  NOSTRAND  COMPANY,  INC. 

120  Alexander  St.,  Princeton,  New  Jersey 

{Principal  Office) 

24  West  40  Street,  New  York  18,  New  York 

D.  Van  Nostrand  Company,  Ltd. 
358,  Kensington  High  Street,  London,  W.14,  Englan 

D.  Van  Nostrand  Company  (Canada),  Ltd. 
25  Hollinger  Road,  Toronto  16,  Canada 


^Copyright  @  1961,  by 
D.  VAN  NOSTRAND  COMPANY,  INC. 


Published  simultaneously  in  Canada  by 
D.  Van  Nostrand  Company  (Canada),  Ltd. 


No  reproduction  in  any  form  of  this  hook,  in 
whole  or  in  part  [except  for  brief  qilutation  in 
critical  articles  or  reviews)  may  be  made  with- 
out written  authorization  from  the  publishers 


printed    in    the    united    states    of    AMERICA 


P'reface 

One  day,  while  this  book  was  still  in  preparation,  I 
was  chatting  with  a  student  who,  amiably  but  not  very 
discerningly,  asked  if  it  would  be  the  first  to  appear 
in  the  psychiatry-religion  area.  In  reply  I  pointed  to 
two  piles  of  books,  each  nearly  two  feet  high,  on  a 
nearby  table  and  suggested  that  he  run  his  eye  down  over 
the  titles.  Here,  I  told  him,  was  only  a  part  of  my  per- 
sonal collection  of  such  books  and  added  that  there  are 
many  more  which  I  do  not  possess. 

The  more  pertinent  question,  therefore,  is  why  should 
I,  why  should  anyone,  write  yet  another  book  in  tLw 
area?  The  answer,  to  which  the  prosp?^'  reader  is 
immediately  entitled,  is  that  tl^'3  book  '-  duferent — in  a 
way  which,  at  least  crudely,  can  be  quickly  stated.  The 
typical  psychiatry-religion  book,  subtly  or  boldly,  promises 
"peace  of  mind"  to  the  reader  on  the  premise  that  psy- 
chiatry is  wonderful,  religion  is  wonderful,  put  them 
together  and  you  get  something  better  still!  More  accu- 
rately, the  situation  might  be  likened  to  that  of  two 
aging  lovers  who  have  married,  each  with  the  illusion 
taat  the  other  has  "lesources"  which  have  been  implied 
but,  thus  far,  not  concretely  exhibited.  The  thesis  of 
this  collection  of  articles  and  lectures  is  that  the  honey- 
moon '3  now  coming  to  an  end  and  that  crisis,  not 
connubial  bliss,  is  the  term  we  need  to  describe  the 
resulting  situation. 

This  book  contains,  therefore,  no  "prescription  for 
anxiety,"  according  to  the  familiar  formula.  Here  we 
shall  proceed  on  the  assumption  that  our  problems  in 
this  area  are  not  purely  ''personal"  but  have  instead 
broadly  social,  historical,  scientific,  and  professional  di- 
mensions. And  the  invitation  to  the  reader  is  thus  to 
join  in  a  quest  and  a  commitment  which,  while  not 
immediately  "anxiety  reducing,"  may,  in  the  long  run, 
be  more  so  than  the  soothing,  personalized  approaches 

iii 


IV 


Prefaci 


which  are  today  being  offered  in  such  profusion.  In  othei" 
words,  to  borrow  a  useful  distinction  from  the  sociologisl^ 
C.  Wright  Mills,  it  seems  that  instead  of  merely  having 
troubles — of  a  highly  particularized  sort,  to  which  there  ^ 
are  known,  readily  available,  standard  solutions — we  here^ 
face  broad  and  complex  issues,  which  must  be  recognized^ 
openly  and  honestly,  and  dealt  with  accordingly.  ' 

Until  roughly  a  century  ago,  psychology,  philosophy^ 
and  religion,  in  both  the  popular  and  academic  mind.' 
were  essentially  one  discipline.  But  then,  in  an  attempl' 
to  separate  the  empirical  from  the  speculative,  the  scien-^ 
tific  from  the  metaphysical,  psychology  and  its  medical 
counterpart,  psychiatry,  made  a  determined  effort  tc 
establish  themselves  as  independent  enterprises.  In  certain 
limited  respects,  this  separation  or  fissioning  has  been' 
successful;  but  in  other,  perhaps  more  important  ways, 
it  has  brought  serious  difficulties  in  its  wake.  Human 
beings,  whether  in  sickness  or  in  health,  are  manifestly 
not  divided  into  clear-cut  psychological,  philosophical, 
and  religious  entities.  And  our  efforts,  in  the  separate' 
professions,  to  understand  and  minister  to  human  need 
have  been  far  less  effective  than  we  would  like.  In  light 
of  this  situation,  it  is  understandable  that,  for  some  years 
now,  there  has  been  a  tendency,  particularly  on  the  part 
of  psychiatry  and  religion,  to  "get  together"  again. 
Certainly  there  is  much  to  commend  and  support  such 
a  movement;  but  there  are  also  some  major  complications 
— which  constitute  the  crisis  with  which  this  book  is 
centrally  concerned. 

Traditionally,  it  has  been  recognized  that  man  is  pre- 
eminently a  social  being — or,  in  theological  phrase,  a 
"child  of  God."  However,  clinical  psychology  and  psy- 
chiatry, in  an  effort  to  consolidate  their  separation  from 
religion,  have  been  powerfully  attracted  by  the  alterna- 
tive emphasis  of  Freudian  psychoanalysis  upon  the  bio- 
logical, rather  than  social  and  moral,  nature  of  man's 
deepest  aspirations.  Currently,  in  this  area,  we  are  hear- 
ing a  good  deal  about  a  new  interest  in  values.  More 
precisely,  we  should  refer  to  this  as  merely  a  change  in 
our  conception  of  the  good,  the  valuable.  Psychoanalysis 
has  always  had  (at  least  tacitly)  a  "value  system,"  one 
in  which  "adult  genital  sexuality"  (capacity  for  lusty 
heterosexual  orgasm)  and  unencumbered  "assertiveness" 


ElEFACE  V 

vhich  often  eventuates  as  frank  hostility  and  aggressive- 
^ss)  occupy  positions  of  supreme  importance. 
In  psychiatry  and  cHnical  psychology  there  is  now, 
elatedly,  a  growing  realization  that  such  a  disingenuous 
Qorality  is  more  likely  to  cause  than  cure  personality 
Jviation  and  disorder.  But,  paradoxically,  this  re-awaken- 
g  on  the  part  of  the  secular  professions  concerned  with 
waling  is  currently  a  barrier,  rather  than  an  asset,  in 
eir  efforts  to  interact  with  religion;  for  the  latter  has 
so  been  deeply  saturated  with  this  same  disingenuous 
)Ctrine  and  is  having  a  hard  time  shaking  free  of  it. 
major  objective  of  the  present  collection  of  recently 
iblished  papers  and  lectures  is  to  facilitate  the  process 
disenchantment  and  thus  help  liberate  religion  for 
e  more  substantial  accomplishments,  both  in  conjunc- 
)n  with  psychology  and  psychiatry  and  in  its  own  right, 
lich  seem  to  be  clearly  within  its  reach — and  also, 
)pefully,  to  help  psychology  and  psychiatry,  in  what- 
er  collaboration  with  religion  may  be  logically  indi- 
ted, to  develop  in  more  promising  and  effective  di- 
ctions. 

This  book  is  therefore  addressed  primarily  to  psycholo- 
its  and  psychiatrists,  on  the  one  hand,  and  to  semi- 
jrians  and  clergymen,  on  the  other,  but  also  to  the 
mbers  of  such  ''intermediate"  professions  as  educa- 
»n,  social  work,  and  law.  Manifestly  it  is  not  a  text- 
ok,  in  the  conventional  sense  of  the  term;  yet,  on  two 
Jerent  occasions,  a  mimeographed  version  thereof  has 
Ted  very  satisfactorily  in  this  role.  During  the  Spring 
nester  of  this  year,  Dr.  Perry  London  and  I  gave  an  ad- 
nced  graduate  seminar  on  "The  Nature  and  Manage- 
nt  of  Guilt,"  with  these  materials  as  the  focus  of  our 
ention;  and  during  the  summer  I  also  used  these  ma- 
ials  as  a  "text"  in  a  course  on  "Mental  Hygiene  for 
;achers."  But  this  book  will  very  likely  find  its  greatest 
idemic  usefulness  as  supplementary  reading  and  as  the 
sis  for  special  discussions  in  a  variety  of  subject-matter 
;as. 

This  is  not  to  say,  of  course,  that  more  systematic  and 
borate  treatises  will  not  ultimately  be  written  from 
I  standpoint  of  the  general  position  which  is  here 
ighly  delineated.  We  are,  I  believe,  definitely  in  proc- 
j   of  abandoning  psychoanalysis,   both   as   personality 


VI 


PrefacI 


theory  and  as  would-be  therapy — and  also,  very  possiblj 
those  forms  of  theology  which  have  allowed  themselvej 
to  become  most  seriously  adulterated  by  it.  To  the  d 
tent,  then,  that  this  book  expedites  such  development' 
it  is  admittedly  "negative,"  ''destructive."  But  it  alsj 
points,  hopefully  and  unequivocally,  to  the  social  bas' 
of  both  the  genesis  and  correction  of  psychopatholog* 
and  thus  provides  the  basis  for  a  broad  and  potential] 
very  powerful  and  constructive  attack  upon  our  problen 
in  this  area. 

Some  readers  will,  I  imagine,  sense  a  similarity  h 
tween  this  approach  and  that  somewhat  amorphous  bi 
presently  vigorous  movement  known  as  Existentialisn 
To  the  extent  that  the  latter  is  in  revolt  agairisMth 
denial  and  debasement  of  human  responsibility  whic 
have  been  foisted  upon  us  alike  by  Calvinist  theology 
Freudian  psychoanalysis,  and  academic  Behaviorism,  th 
present  approach  is  indeed  similar.  But  here  the  readd 
will,  I  trust,  find  none  of  the  cultishness  and  mysticisij 
which  so  often  characterize  Existentialism,  in  its  varioii 
forms.  Here  the  aim  is  to  keep  well  within  the  bound 
of  common  sense  and  scientific  thought,  but  at  the  sarn 
time  to  take  a  sufficiently  broad  view  of  the  human  entd 
prise  to  include  also  a  considerable  segment  of  what  ' 
ordinarily  termed  "morality"  and  "religion."  ' 

Much  of  the  incentive  for  bringing  this  collectio 
of  documents  together  in  book  form  comes  from  tli 
friendly,  yet  thoughtful  and  concerned  way  in  whic 
they  have  been  received,  as  articles  and  lectures,  by  th 
various  professional  and  lay  groups  to  which  they  ha\ 
been  addressed.  These  reactions  have  been  both  a 
encouragement  and  a  challenge,  for  which  I  am  extreme] 
grateful.  The  title  of  each  chapter  is  followed  by 
footnote  which  indicates  the  chapter's  origin:  if  a 
article,  the  place  of  prior  publication;  if  a  lecture,  tli 
circumstances  of  its  delivery.  And  at  the  outset  of  eac 
chapter  there  is  also  a  brief  introductory  statemen 
designed  to  highlight  the  argument  of  the  book  as 
whole  and  to  link  successive  chapters  together.  Howeve 
it  is  here  that  I  wish  to  express  my  very  warm  appreci. 
tion  to  the  Pacific  School  of  Religion  for  the  invitatio 
to  deliver  the  E.  T.  Earl  Lectures  for  1960  and  to  Nort 
Park  College  and  Seminary  for  a  similar  opportunity  1 


I^^REFACE  Vii 

jive  the  David  Nyvall  Lectures  for  1960.  These  lectures 
ire  reproduced  in  full,  as  Chapters  8,  9,  and  10,  and 
[l  and  12,  respectively.  And  in  September,  the  latter 
jvere  presented,  as  the  first  of  the  Geehns  Lectures  for 
ihis  academic  year,  at  the  Southern  Baptist  Theological 
Seminary,  in  Louisville,  Kentucky.  I  shall  long  remember, 
^^ith  much  pleasure,  the  many  personal  courtesies  ex- 
fended  to  me  on  these  occasions  and  the  helpfulness  of 
he  comments  and  criticisms  which  I  thus  received. 
!  Also,  I  take  pleasure  in  acknowledging  the  gener- 
osity of  those  authors  and  publishers  who  have  granted 
permission  to  quote  from  other  works,  and  in  expressing 
py  gratitude  to  Miss  Leona  D.  Pedigo  and  Mrs.  Donald 
fV.  Keefer  for  highly  competent  secretarial  assistance  in 
^e  preparation,  proofing,  and  indexing  of  this  book. 
I  Although  the  materials  here  assembled  were  originally 
lirected,  in  most  instances,  to  professional  audiences — 
)sychiatrists,  psychologists,  educators,  and  theologians, 
he  language  is  essentially  nontechnical  and  can  be  un- 
lerstood  by  any  interested  layman.  And  because  the  issues 
mder  discussion  are  so  vital  to  our  very  existence,  both 
s  individuals  and  as  a  people,  I  believe  that  many  lay- 
nen,  as  well  as  specialists,  will  be  interested.  To  this 
nd,  the  book  has  been  deliberately  kept  small  and  the 
ormat  inexpensive. 

O.  H.  M. 

Urhana,  Illinois 

December y  I960 


Contents 

1.  Some  Philosophical  Problems  in  Psycho- 

logical Counseling 

2.  Changing    Conceptions    of    the    Uncon- 

scious 

3.  Some  Constructive  Features  of  the  Con- 

cept OF  Sin 

4.  "Sin,"  The  Lesser  of  Two  Evils 

5.  Judgment    and    Suffering:     Contrasting 

Views 

6.  The  New  Challenge  to  Our  Churches 

AND  Seminaries:  I.  A  Question  of  Theory 

7.  The  New  Challenge  to  Our  Churches 

AND  Seminaries:  II.  The  Problem  of  Ac- 
tion 

8.  Psychopathology   and    the    Problem    of 

Guilt,  Confession,  and  Expiation 

9.  Psychotherapy  and  the  Problem  of  Val- 

ues IN  Historical  Perspective  or  The 
Devil  and  Psychopathology 

10.  Psychology,   Theology,   and   the    Social 

Self 

11.  Protestant  Christianity:  I.  Ambiguity  and 

Disaster 

12.  Protestant  Christianity:  II.  Challenge  and 

Change 

13.  Footnotes  to  a  Theory  of  Psychopathol- 

ogy 
Bibliography  and  Author  Index 
Subject  Index 


To 

CRYSTAL  MOWRER  SMITH 

and 

GLADYS  DURDEN  COOK 

with  gratitude  for  their  faith  in 
the  ultimate  unity  of  psychology  and  religion 


I 


Some  Philosophical  Problems 
in  Psychological  Counseling* 

This  paper  is  centrally  concerned  with  certain  historical 
md  cultural  dimensions  of  the  crisis  in  psychiatry  and 
eligion.  Academic  psychology  [particularly  here  in  Amer- 
ca)  and  Freudian  psychoanalysis  (an  indigenous  Euro- 
pean movement)  were  both  powerfully  influenced  by 
he  Darwinian  conception  of  organic  evolution,  which 
egarded  mind  as  essentially  an  ''organ  of  adaptation.'* 
This  type  of  approach  has,  in  some  ways,  been  extremely 
iseful.  However,  there  are  today  signs  of  acute  unrest  in 
ioth  psychiatry  and  psychology.  Personal  disorganization 
md  psychopathology  persist  as  great  unsolved  problems 
n  our  time;  and  there  is  growing  conviction  that  the 
ninciples  and  conditions  of  biological  adaptation  and 
urvival  do  not  necessarily  provide  the  understanding 
ieeded  for  psychological  survival.  Human  beings  are 
nore  than  mere  bodies,  organisms,  physiological  entities; 
^hey  are  also  persons.  And  personality,  it  seems,  can  be 


\  *  Previously  published  in  the  Journal  of  Counseling  Psychol- 
ogy, 1957,  4,  103-111;  also  read,  under  a  different  title  ("A 
i*ractical.  Contemporary  Aspect  of  the  Mind-Body  Problem"), 
t  the  Eighth  Annual  Institute  in  Psychiatry  and  Neurology  held, 
jinder  the  auspices  of  the  Veterans  Administration,  in  North  Lit- 
le  Rock,  Arkansas  (March,  1956).  Between  then  and  the 
Ime  of  original  publication,  a  number  of  other  pertinent  refer- 
Tices  came  to  the  writer's  attention  and  were  listed,  for  the 
eader's  convenience,  as  follows:  Blake  (1955),  Fingarette 
'1955),  Gallagher  (1956),  Hobbs  (1956),  Liften  (1953), 
ylaslow  (1956),  Roberts  (1956),  Schneiderman  (1954),  Sho- 
,.en  (1955,  1956),  Waiters  (1955),  White  (1952),  and  Wil- 
[amson  (1956).  And  to  this  list  a  comment  was  added,  "Al- 
hough  these  papers  do  not  by  any  means  all  take  the  same 
losition  as  does  the  present  author,  they  are  unanimous  in 
ailing  for  a  re-appraisal  of  the  philosophical  premises  on  which 
ontemporary  psychotherapy,  counseling,  and  even  diagnosis  are 
redicated." 


2  The  Crisis  in  Psychiatry  and  Religion 

'  properly  understood  and  appreciated  only  in  terms  of 
sociality,  i.e.,  interpersonal  and  moral  values  systems. 

Religion  is,  of  course,  deeply  concerned  with  man  as 
person  and  personality;  and  in  their  shifting  percep- 
tion of  man-as-hody  to  man-as-person,  psychology  and 
psychiatry  find  themselves  looking  again,  with  renewed 
interest  and  respect,  at  religious  precept  and  practice. 
Whatever  may  he  the  incompatibility  of  religion  and 
these  secular  disciplines  in  the  metaphysical  realm,  here, 
in  the  study  of  personality  in  its  social  and  ethical  dimen- 
sions, is  a  natural  and  favorable  meeting  place.  Although 
it  is  at  present  impossible  to  foresee  how  far  the  rap- 
prochement of  religion  and  psychiatry,  broadly  con- 
ceived, will  eventually  go,  here,  manifestly,  is  the  place 
to  start. 

Is  mind  designed  to  serve  the  body  or  is  body  designed 
to  serve  the  mind?  During  the  last  half  century,  assent 
has  been  so  nearly  universally  given  by  psychologists  to 
the  first  of  these  possibilities  that  the  alternative  view 
has  hardly  been  considered  at  all. 

But  there  are  signs  that  all  is  not  well  with  psychology, 
either  as  science  or  as  profession,  and  that  we  may  need 
to  re-examine  some  of  our  most  basic  assumptions.  Ask 
a  representative  sample  of  bright,  young  clinical  psychol- 
ogists who  got  their  doctorate  degrees  at  our  best  uni- 
versities four  or  five  years  ago  and  who  have  since  been 
on  the  clinical  firing  line,  ask  them  what  they  now  think 
of  their  training  in  light  of  their  attempts  to  make  appli- 
cation thereof.  Without  bitterness,  self-pity,  or  even 
undue  pessimism,  they  commonly  express  doubts  of  the 
most  profound  and  far-reaching  nature.  They  question 
both  the  instruments  and  the  categories  of  diagnosis; 
they  feel  that  the  rationale  and  results  of  psychotherapy 
and  counseling  are  uncertain;  and  they  divergently  evalu- 
ate the  significance  of  recent  contributions  to  psychology 
as  a  science. 

Or,  listen  to  what  some  of  our  elder  statesmen  have 
to  say  in  this  connection.  In  1955  the  American  Psychi- 
atric Association  sponsored  an  all-day  symposium,  by 
psychiatrists  and  psychologists,  on  psychotherapy— later 
published  in  book  form  under  the  title.  Progress  in  Psy- 


Philosophical  Problems  in  Counseling  3 

chotherapy    (Fromm-Reichmann   and   Moreno,    1956). 
Here  are  some  of  the  comments  made  on  this  occasion: 

Psychiatry  has  a  great  need  for  a  clear  and  rational 
understanding  of  the  process  of  recovery.  .  .  .  Hypotheses 
we  have,  .  .  .  but  none  has  gained  that  degree  of  validation 
which  should  serve  to  command  general  acceptance  in  the 
medical  profession  as  a  well-established  theory  (Whitehorn, 
p.  62). 

Psychotherapy  has  many  more  variants  than  psychoanalysis 
and  what  constitutes  psychotherapy,  and  what  does  not,  is 
even  less  clear  than  what  is,  or  is  not,  psychoanalysis.  .  .  . 
The  time  has  come  to  investigate  not  the  differences  but  the 
similarities,  and  to  formulate  common  denominators  among 
the  bewildering  array  of  different  methods  and  procedures 
(Hoch,  pp.  72-73). 

It  is  discontent  which  drives  me  in  my  approach  to  this 
problem.  Only  a  few  years  ago  (although  it  seems  a  long 
time  in  my  life  as  a  psychoanalyst)  I  harbored  the  comfort- 
ing expectation  that  increasing  analytic  sophistication  and 
experience  would  yield  a  higher  percentage  of  therapeutic 
successes.  .  .  .  My  reluctant  impression  is  that  this  hope 
has  not  been  realized  (p.  87).  I  am  impatient  with  any 
propagandish  approach  to  the  problem  from  any  point  of 
view.  We  have  no  right  to  be  for  or  against  anything  in 
this  field.  We  have  a  right  only  to  the  most  complete 
humility — humility  that  says  we  still  know  practically  nothing 
about  many  important  elements  either  in  the  neurotic  process 
or  in  the  psychotherapeutic  process)   (Kubie,  p.  101). 

Psychotherapy  is  today  in  a  state  of  disarray,  almost  ex- 
actly as  it  was  two  hundred  years  ago  (p.  108).  At  this  stage 
we  seem  to  be  fighting  each  other  to  attain  some  sort  of 
theoretic  throne,  and  we  often  forget  that  that  throne  is  as 
unsteady  as  a  three-legged  chair  (Zilboorg,  p.  110). 

Or,  take  still  a  different  sort  of  evidence  that  we  have 
failed  to  meet  manifest  social  need  in  this  connection. 
One  of  the  most  remarkable  and  unanticipated  develop- 
ments on  the  whole  contemporary  human  scene  is  the 
extent  to  which  religious  leaders  are  thinking  about  and 
actively  working  at  the  problem  of  personality  disorder. 
Books  on  religion  and  pastoral  counseling  are  being  pub- 
lished at  an  unprecedented  rate,  and  if  one  takes  the 
trouble  to  examine  them,  one  finds  that  they  are  some- 
times quite  thoughtful,  informed,  and  creative.  "Men- 
tal Health"  is  a  common  pulpit  topic;  and  to  the  twin 


4  The  Crisis  in  Psychiatry  and  Religion 

concepts  of  "Sin  and  Salvation"  has  been  added,  "and 
Sanity."  Moreover,  and  even  more  remarkable,  it  seems 
that  the  profession  of  psychiatry  is  now  beginning  to 
think  in  a  new  way  about  the  role  of  religion  in  mental 
health  and  illness:  witness  the  just-published  books  by 
Viktor  Frankl  of  Vienna  (1953)  and  by  the  English 
psychiatrist,  Ernest  White  (1955).  For  similar  trends 
in  this  country,  see  The  Church  and  Mental  Health 
(Maves,  1953)  and  Ministry  and  Medicine  in  Human 
Relations  (Galdston,  1955).  And  the  same  trend  is  also 
conspicuous  in  Progress  in  Psychotherapy  (Fromm-Reich- 
mann  and  Moreno,  1956). 

Granted,  then,  the  reality  of  psychology's  ailment, 
what  precisely  is  the  diagnosis,  what  the  remedy? 

THE   "biologizing"   OF   AMERICAN   PSYCHOLOGY 

The  writer  has  just  read  Boring's  paper  (1950)  on 
"The  Influence  of  Evolutionary  Theory  upon  American 
Psychological  Thought."  It  is  most  suggestive.  Boring 
begins  by  noting  a  paradox,  that  in  the  latter  part  of  the 
nineteenth  century,  American  psychologists  were  busy 
ostensibly  imitating  and  importing  one  kind  of  psy- 
chology from  Germany  while,  almost  unwittingly,  creat- 
ing something  very  different.  This  was  Functionalism 
and,  a  little  later.  Behaviorism.  Here  Darwinian  thought 
was  the  touchstone.  Says  Boring: 

To  his  thinking  about  psychology  Dewey  brought  the  con- 
cept of  functional  use  for  the  events  of  the  mind,  and  thus, 
closely  related  to  functional   use,  the  notion  of  functional 
/activity.  The  way  to  express  this  matter  is  to  say  that  both 
I  consciousness   and   activity   function   for  the   organism — the 
luse  of  consciousness  is  to  produce  activity  which  "saves"  the 
organism.  That  is  the  essential  tenet  of  the  Chicago  school  of 
functional  psychology  which  Dewey  started,  and  which  An- 
gell  carried  on.  In  the  doctrine  of  this  school  behavior  and 
physiology  and  conscious  states  are  mixed  in  with  each  other 
because  they  are  unified,  not  by  their  essential  natures,  but 
by   their   common   aim   for   the   survival   and   use   of    the 
organism  (p.  277). 

Boring  then  goes  on  to  say  that,  in  his  judgment 
(Watson  to  the  contrary).  Behaviorism  was  a  direct 
outgrowth  "of  Dewey's  functionalism  and  of  Cattell's 


Philosophical  Problems  in  Counseling  5 

capacity  psychology.  .  .  .  Watson's  view  was  essentially 
American,  a  psychology  consistent  with  the  [pioneer  and 
democratic]  belief  in  necessity  of  struggle  for  survival" 
p.  288). 

Radical  Behaviorism  is  today  antiquated,  on  two  scores, 
(a)  Its  adherents,  in  the  pursuit  of  their  own  objectives, 
have  found  it  increasingly  necessary  to  make  use  of 
"intervening  variables."  And  (b)  the  spread  of  interest 
in  clinical  psychology  has,  again  of  necessity,  focused 
interest  upon  mind  rather  than  upon  body,  upon  dis- 
turbances of  consciousness  rather  than  upon  questions  of 
biological  adaptation.  As  Boring  observes: 

Behaviorism  was  itself  too  unsophisticated  to  last.  It  has 
now  given  place  to  positivism  or  operationism  or  whatever 
one  prefers  to  call  the  newest  psychological  objectivism.  The 
operationist  argues  that  all  the  data  of  psychology,  including 
the  data  of  consciousness,  are  to  be  defined  by  the  operations 
which  are  used  to  observe  them.  You  can  know  nothing 
more  about  mind  than  you  can  find  in  the  evidence  for  the 
existence  of  mind.  This  movement  gets  its  sophistication 
from  the  logical  positivism  of  the  Vienna  Circle  and  from 
the  operational  physics  of  P.  W.  Bridgman,  but  this  is  not 
the  place  for  its  full  consideration.  It  is  sufficient  here  to 
point  out  that  the  epistemology  of  operationism  was  already 
implicit  in  the  faiths  of  behaviorism,  functional  and  capacity 
psychology,  the  basic  American  psychological  faith  (p.  288). 

It  is  not  the  purpose  of  the  present  paper  to  suggest 
that  this  faith,  this  ''basic  American  psychological  faith," 
has  been  completely  misplaced  or  entirely  unfruitful. 
The  present  author  (Mowrer,  1960a);  has  spent  the 
past  several  months  reviewing  the  research  and  theoretical 
literature  to  which  this  faith  has  given  rise  in  the  field 
of  learning;  the  results  are  undeniably  impressive.  The 
question  is  whether  this  faith  is  as  broad,  as  inclusive, 
as  far-reaching  as  it  ought  to  be. 

Functional  psychology  becomes  the  study  of  the  organism 
in  use.  Functional  psychology  is  thus  practical  through  and 
through  in  the  way  that  Darwin's  theory  was  the  greatest 
practical  theory  of  living  that  has  ever  been  put  forth  (Boring, 
1950,  p.  277). 

Here,  then,  is  the  crux  of  the  issue.  Is  it  indeed  true 
that  mind  is  designed  to  serve  the  body  (which  is  pre- 
sumably what  is  meant  here  by  "practicality")?  Or  is 


6  The  Crisis  in  Psychiatry  and  Religion 

there  a  reciprocal  relationship  of  some  sort,  in  which  the 
body  must  become  obedient,  even  subservient  to  mind? 
One  hesitates  to  ask  this  question  because  of  its  clearly 
anachronistic  ring.  Religion  has  always  insisted  that  soul 
is  more  important  than  body,  that  the  flesh  should  be  sub- 
jugated by  the  spirit.  And  the  *'old  psychology,"  against 
which  Functionalism  and  Behaviorism  were  so  strenuously 
— and  not  without  reason — rebelling,  was  based  upon 
presuppositions  closely  akin  to  those  of  theology.  Boring 
calls  attention  to  "the  influence  of  seventeenth  century 
theology  upon  Descartes,  an  influence  abetted  by  lan- 
guage." In  French  Vame,  he  notes,  may  be  interpreted 
either  as  mind  or  soul,  and  the  same  is  true  of  the  Ger- 
man word,  Seele.  Since  one  does  not  attribute  a  *'soul" 
to  animals,  there  was,  then,  a  tendency  to  deprive  them 
of  "mind"  (and  consciousness)  as  well. 

The  Darwinian  theory,  on  the  contrary,  asserted  the  exist- 
ence of  continuity  between  man  and  animals,  continuity  in 
all  respects,  mental  as  well  as  physical,  since  man  is  believed 
to  be  derived  from  animals  by  continuous  change  (Boring, 
1950,  pp.  284-285). 

There  is  no  doubt  that  much  has  been  accomplished 
by  the  Darwinian,  the  organic,  the  mechanistic  approach 
to  mind.  Many  things  of  a  psychological  nature  are  now 
clearly  and  systematically  understood  in  objective  terms 
which  were  simply  given,  seemingly  unanalyzable,  in  a 
psychology  which  made  conscious  experience  all  impor- 
tant. And  with  the  physical  models  and  thought  forms 
provided  by  modern  servo  theory,  it  seems  that  we  have 
by  no  means  yet  fully  exploited  or  exhausted  what  can 
be  done  along  these  lines.  But  we  must  return  to  the 
thesis  that  all  is  not  well  with  contemporary  psychological 
science.  To  assume  otherwise,  in  face  of  the  manifest 
realities,  is  hazardous — and  a  betrayal  of  the  ideals  of 
science  itself. 

BIOLOGICAL  VERSUS   PSYCHOLOGICAL   SURVIVAL 

The  fact,  the  decidedly  inconvenient  but  seemingly 
inescapable  fact,  is  that  man  must  be  concerned  with 
the  struggle  for  psychological  survival,  as  well  as  with 


Philosophical  Problems  in  Counseling  7 

physical,  organic,  bodily  survival.  Indeed,  he  has  already 
succeeded  so  well  in  the  latter  respect  that  his  very 
success  now  constitutes  one  of  our  most  pressing  dilem- 
mas (waning  natural  resources  and  a  world  population 
that  is  increasing  at  the  net  rate  of  75,000  persons  per 
day)  [cf.  also  Chapter  13].  But  in  the  struggle  for^ 
psychological  survival,  we  seem  to  be  groping  for  first 
principles.  Whether,  in  absolute  terms,  there  is  more 
"mental  disease"  in  this  country  than  formerly  is  perhaps 
open  to  question;  but  relatively — relative,  that  is,  to 
physical  illness  and  incapacity — psychological  and  emo- 
tional disorders  are  so  clearly  in  the  lead  that  it  is  now 
trite  to  refer  to  them  as  "the  nation's  number-one  health 
problem,''  the  plague  of  modern  times. 

We  have  remarked  upon  the  considered  skepticism 
and  disillusionment  of  our  bright  young  men  in  clinical 
psychology.  And  we  have  also  seen  what  some  of  our 
more  mature  writers  have  to  say  about  the  field  of 
psychotherapy.  Moreover,  under  the  urgency  of  the  grow- 
ing popular  demand  that  "something  must  be  done," 
men  in  positions  of  responsibility  and  public  trust  have 
openly  declared  that  if  a  new  "breakthrough"  does  not 
soon  come  in  the  field  of  mental  health,  they  will  be 
forced,  by  the  very  nature  of  their  social  obligations, 
to  start  supporting  research  and  training  outside  the 
acknowledged  professions  of  psychiatry,  clinical  psychol- 
ogy, social  work,  and  psychiatric  nursing — not,  perhaps, 
with  much  conviction  but  out  of  sheer  desperation.^ 

The  professions  just  mentioned  have,  by  and  large, 
pinned  their  hopes  to  psychoanalysis.  This  body  of  theory 
and  practice  needs  no  criticism  here;  the  logic  of  events 
seems  to  be  making  purely  verbal  objections  gratuitous. 
While  the  present  writer  has  previously  joined  in  the 
attack  upon  psychoanalysis,  he  now  has  no  zest  for  further 
criticism.  If  one  can  correctly  interpret  the  course  of 
on-going  developments,  they  clearly  signify  the  failure 

^  Since  the  above  was  written,  the  National  Institute  of  Men- 
tal Health  (of  the  U.  S.  Public  Health  Service)  has  approved 
several  "pilot  study"  grants  for  training  of  personnel  in  psy- 
chopharmacology,  neurophysiology,  sociology,  theology,  and 
other  "peripheral"  professions.  Note  also  the  work  of  the  newly 
established  Joint  Commission  on  Mental  Illness  and  Health. 


8  The  Crisis  in  Psychiatry  and  Religion 

of  this  movement,  leaving  one  only  to  say,  perhaps, 
''More's  the  pity.  Things  would  have  been  so  much 
simpler,  so  much  easier  if  Freud  had  only  been  right!" 
But  if  reality  is  not  as  he  thought,  then  the  sooner  and 
more  completely  we  recognize  his  errors  the  better. 
/j  We  need  hardly  remind   ourselves   that  Freud  was 
!*/  strongly  influenced  by  the  same  forces  that  shaped  the 
"new  psychology"  in  America.  We  know,  by  his  own 
repeated  statement,  that  as  a  youth  Freud  read  and 
greatly  admired  Darwin,  and  the  influence  is  evident: 
for  Freud,  neurosis  was  the  result  of  cultural    (moral, 
religious)    interference   with   normal   physiological    (in- 
stinctual) processes.  The  mind,  if  dominated  by  certain 
mistaken  social  values,  may  cease  to  serve  the  body  and 
I  obstruct    its    functions.    The    body   then    protests    and 
I   retaliates.  T/icrt  is  ''neurosis,"  and  the  crux  of  Freudian 
\   psychopathology.  Here  we  see  Functionalism  and  Scien- 
'    tific  Materialism   applied   to   Twentieth-Century  man's 
most  pressing  problem.  Are  they  indeed  so  eminently 
\;j  practical?  Are  they  really  the  greatest  ''theory  of  living 
that  has  ever  been  set  forth"? 

Let  us  not  sell  them  short.  Functionalism  and  Scien- 
tific Materialism  provided  the  intellectual  climate  and 
basic  premises  which  have  made  possible  unprecedented 
advances  in  our  knowledge  of  animal  behavior  and  have 
laid  the  foundation  for  attacking  some  distinctively 
human  problems — for  example,  the  psychology  of  lan- 
guage— ^with  new  insights  and  confidence  (Mowrer, 
1960b).  Perhaps  we  merely  lack  patience.  Give  them 
time  and  opportunity  to  demonstrate  their  ultimate 
potency.  Indirect  report  has  it  that  one  of  the  few  re- 
maining extreme  Behaviorists  has  recently  begun  re- 
searches with  severely  disturbed  psychiatric  patients  and 
that  the  therapeutic  results  already  obtained  are  remark- 
able. All  power  to  this  project.  But  sanguine  hopes  were 
expressed  decades  ago  for  what  the  New  Psychology 
would  do  for  the  field  of  mental  hygiene  (Angell,  1907). 
It  has  not,  sad  to  say,  borne  the  hoped-for  fruit.  Let  no 
hunch  go  neglected  here.  But  neither  history  nor  the 
contemporary  scene  provides  grounds  for  much  confidence 
that  the  solution,  if  solution  there  be,  lies  in  that  direc- 
tion. 
What  other  alternatives  are  there? 


Philosophical  Problems  in  Counseling 


rHE  NEED  FOR  A  TRULY  MENTAL  HYGIENE 

Is  it,  then,  improper  to  explore  the  possibility  that  the 
body  must  serve  the  mind,  as  well  as  mind  serve  the 
body?  While  mind  presumably  evolved  because,  as  Boring 
^serves,  it  ''saves"  the  body,  yet  once  evolved  it  appears 
that  mind  has  its_owrispecial  needs,  its  own  conditions 
[oT_jm}D^ii2l^.Jts_joym^^^g^  culture.  And  we  must 

then  ask,  How  and  inwhaFsense  the  body  can  serve  and 
"save"  the  mind? 

For  psychologists,  this  is  a  dangerous  question  to 
consider;  for  if  it  is  answered  at  all  affirmatively — if  we 
Donclude  that  body  must  serve  mind,  it  brings  us  imme- 
diately into  a  domain  where  we  are  by  no  means  authori- 
ties, but  rank  amateurs.  Religion  has  steadfastly  said, 
save  in  its  weaker  moments,  that  conduct  must  be  guided 
by  the  needs  of  the  spirit  as  well  as  those  of  the  body. 
/\nd  some  of  the  best  minds  of  all  ages  have  devoted 
themselves  to  working  out  patterns  and  precepts  of  con- 
duct which  are  "holy"  (integrative,  redemptive,  health- 
giving,  therapeutic).  Here,  not  only  are  we  psychologists 
relatively  uninformed;  we  have  sat,  alas,  in  the  seat  of 
scorn  and  have  barriers  of  pride  and  deep  bias  to  over- 
come before  we  can  become  even  apt  students,  much 
less  teachers  and  trustworthy  leaders  in  this  area. 

Let  it  be  at  once  granted  that  religion  has  sometimes 
taken  an  extreme  and  indefensible  position  in  this  con- 
nection. Sometimes  it  has  said  that  not  only  must  the 
body  be  subservient  to  mind  and  soul;  the  body  must 
also  be  despised  and  continually  chastized.  No  greater 
or  more  clarion  voice  ever  cried  out  against  this  perver- 
sion than  that  of  Martin  Luther.  Said  he: 

No  Christian  should  despise  his  position  and  life  if  he  is 
living  in  accordance  with  the  word  of  God,  but  should  say,  "I 
believe  in  Jesus  Christ,  and  do  so  as  the  ten  commandments 
teach,  and  pray  that  our  dear  Lord  God  may  help  me  thus 
to  do."  That  is  a  right  holy  life,  and  cannot  be  made  holier 
even  if  one  fast  himself  to  death.  .  .  . 

Huss  has  been  burned,  but  not  the  truth  with  him  (Stuber, 
1952,  p.  213). 

Although  Luther  successfully  launched  the  Protestant 
Reformation,  the  philosophy  of  asceticism  is  still  alive 


10  The  Crisis  in  Psychiatry  and  Religion 

within  but  under  debate  by  the  Roman  Church.  Gold- 
brunner    (1955),   an  ordained   priest  and   scholar  well 
known  in  Europe,  has  recently  stated  the  growing  senti- 
ment within  the  Church  against  asceticism,  in  a  most 
interesting  and  energetic  manner.  But  we  need  not  here 
pursue  his  argument  in  detail.  Asceticism  is  clearly  in 
retreat.  Moreover,  it  is  not  indigenous  to  or  an  intrinsic 
part  of  the  Christian  *Vay"  or  life  style.  The  founder 
of  the  movement  did  not  say,  Do  not  eat  at  all.  He  even 
taught  his  students  and  followers  to  give  thanks  for  their 
"daily  bread.'*  But  he  did  insist  that  man  does  not  live 
by  bread  alone.  And  he  spoke  of  a  more  abundant  life,  a 
life  of  the  spirit,  which  was  to  be  achieved  by  relatedness, 
reconciliation,   fellowship — with   man  and  God.   What 
^   does  it  profit  a  man,  he  asked,  if  he  gain  the  whole 
^  world  but  lose  his  mind,  his  soul?  Truly  a  life  with  a 
permanently  disordered  mind  ("unredeemed  soul")  is  a 
^--"life  worse  than  death."  In  insanity  there  is  physical, 
^"biological  survival;  a  compassionate  society  sees  to  that. 
^'  But  to  what  avail? 

^        It  has  been  common  for  us  objectivists  to  psychologize 
^    religion,  to  write  about  the  "psychology  of  religion." 
And  Freud   (1928),  as  we  know,  went  a  step  further 
and   reduced   it  to  a   form   of  psychopathology,   often 
relatively  benign  but  sometimes  thoroughly  malignant. 
•^/TIow  helpful,  how  constructive,  how  genuinely  scientific 
J  have  such  forays  been?  Psychoanalysis  as  a  movement 
;|  is  in  trouble.   Church   attendance  in   this  country,  by 
7  contrast,  is  rapidly  increasing,  well  beyond  population 
/  growth.  In  other  words,  Freud's  "reality  principle"  ap- 
pears to  be  doing  less  well  than  the  "illusion"  with  such 
an  unpromising  future.  Perhaps  Freud  was  still,  in  one 
sense,  right:  maybe  he  was  wrong  only  in  his  estimate 
of  man's  growing  capacity  to  live  without  illusion.  Or, 
can  it  be  that  he  himself  misperceived  "reality"? 

Under  the  sway  of  Darwinian  thought,  we  practical, 
functional,  behavioristic  psychologists  have  tended  to 
dismiss  religion  as  irrelevant  to  both  the  scientific  and 
human  enterprise,  or,  with  Freud,  to  regard  it  as  actively 
inimical  to  soundness  of  body  and  mind  alike.  We  have 
analyzed,  psychologized,  pathologized  religion,  ignoring 
the  possibility  that  it  is,  in  and  of  itself,  a  psychology, 
souMogy  of  the  profoundest  sort.  By  our  own  stated 


Philosophical  Problems  in  Counseling  11 

premises,  our  science  is  a  species,  a  derivative  of  biology, 
physiology,  even  physics.  Religion  represents  man's  at- 
tempt, through  the  ages,  to  meet  mind  on  its  own  terms. 
Can  this  be  a  truer,  more  genuine  psychology  than  our 
own? 

How  to  decide?  The  antiquity  and  continued  vitality 
of  religious  thought  and  action  may  be  said  to  bear  upon 
the  question.  Freud  argued  to  the  contrary.  It  was  some- 
thing, he  said,  that  had  simply  become  lodged,  adven- 
titiously, in  man's  "unconscious"  and  was  perpetuated 
like  some  congenital  physical  weakness  or  disorder.  But 
contemporaneous,  as  well  as  historical,  evidence  suggests 
that  religion,  as  an  institution,  has  survived  for  the  reason 
that  it  often  has  unique  psychological  survival  value  for 
the  individual.  That  it  gave  early  Christians  the  capacity 
to  handle  not  only  the  ordinary  conflicts  and  tensions 
of  life  but  enabled  them  to  persevere  in  the  face  of  and 
eventually  to  overcome  the  most  powerful  political  op- 
position on  the  face  of  the  earth  is  established  history. 
And  in  our  own  time  the  evidence  from  case-histories 
of  "brain  washing"  successfully  withstood  on  religious 
grounds  is  steadily  growing  (see,  for  example,  Perkins, 
1956). 

The  English  psychiatrist,  Ernest  White,  (1955,  p.  H) 
takes  this  position: 

One  often  finds  that  questions  do  not  admit  of  a  clear 
answer  because  the  assumptions  on  which  they  rest  are  false. 
For  example,  after  an  address  had  been  given  on  the  subject 
of  Psychology  and  Religion,  a  member  of  the  audience  asked 
why  it  was  that  so  many  more  neurotic  people  were  found 
inside  the  churches  as  compared  with  people  outside.  Now 
it  is  not  possible  to  answer  such  a  question  unless  it  has 
been  first  demonstrated  by  special  investigation  that  there 
are  in  fact  more  neurotics  in  proportion  among  churchgoers 
than  among  the  general  population.  As  far  as  I  know,  no 
such  investigation  has  been  made. 

Preliminary  attempts,  apparently  not  known  to  White, 
have  been  made  in  this  country  to  get  empirical  evidence 
on  this  point,  with  results  that  give  church  members 
a  comparatively  clean  bill  of  emotional  health  (Link, 
1936,  Chap.  1  and  p.  99).  But  much  more  searching 
study  of  the  issue,  at  the  empirical  level,  is  obviously 
needed.  From  one  point  of  view,  no  neurotic  individuals 


12  The  Crisis  in  Psychiatry  and  Religion 

at  all  should  be  found  in  a  church-going  population.  If 
religion  offers  an  assured  salvation,  this  might  seem  to 
follow  axiomatically.  But  it  would  be  absurd  to  condemn 
hospitals,  as  institutions  of  physical  remediation,  because 
one  finds  so  many  sick  people  in  them.  The  appeal  of 
religious  institutions  has  always  been  addressed  to  "poor, 
sick  souls,"  and  Christ  himself  said  that  he  did  not  come 
to  call  the  righteous.  Hence,  a  study  which  would  be 
faithful  to  both  sides  of  the  argument  needs  to  be  care- 
fully interpreted,  as  well  as  meticulously  impartial. 


COMMON  ground:  the  study  of  interpersonal 

AND  GROUP   RELATIONSHIPS 

It  has  already  been  noted  that  psychologists,  for  reasons 
given,  have  been  hard  to  interest  in  religious  psychology, 
as  opposed  to  objective  psychology  and  psychoanalysis. 
Indeed,  as  Roberts  (1956)  has  observed,  "A  psycholo-  j 
gist  who  is  suspected  of  being  religious  is  at  once  under 
suspicion  of  scientific  incompetence,"  although  the  same 
suspicion  does  not  attach  itself  to  a  physicist,  a  chemist, 
or  an  engineer.  But  there  are  signs  of  change.  A  number 
of  national  organizations  (typified  by  the  National  Acad- 
emy of  Religion  and  Mental  Health )  have  recently  sprung 
up  with   the  avowed  purpose  of  unifying,  or  at  least,  j 
relating,  psychology,  psychiatry,  and  religion;  and,  within  i 
the  American  Psychological  Association  itself,  there  is  s 
now  a  "special  interest  group"  in  this  area  which  has 
held  meetings  at  our  two  most  recent  conventions. 

Perhaps  most  auspicious  of  all  is  the  fact  that  so  many 
psychologists  are  now  turning  their  research  interests 
toward  problems  which  have  long  been  of  concern  to 
religious  and  church  leaders,  notably  problems  having 
to  do  with  social  affiliation  and  what  Foote  and  Cottrell 
(1955)  have  aptly  termed  interpersonal  competence. 
Here  it  is  inevitable  that  psychologists  should  encounter 
many  of  the  same  realities  as  have  interested  religious 
thinkers  and  practitioners  throughout  history.  This  point 
is  well  illustrated  in  a  paper  recently  published  by  Corsini  i 
and  Rosenberg  (1955).  These  writers  did  a  sort  of  in-  ' 
formal  factor  analysis  of  the  contents  of  some  300  con- 


Philosophical  Problems  in  Counseling  13 

temporary  books  and  articles  on  the  subject  of  group 
psychotherapy  and  emerged  with  "ten  classes  of  mechan- 
isms" commonly  emphasized  therein. 

All  of  these  mechanisms,  or  principles,  need  not  be 
considered  here;  but  the  two  which  head  Corsini  and 
Rosenberg's  list  are  these: 

Acceptance.  This  statistically  most  frequent  concept  was 
taken  to  mean  respect  for  and  sympathy  with  the  individual. 
Acceptance  implies  belongingness,  a  warm,  friendly,  com- 
fortable feeling  in  the  group. 

Altruism.  Closely  related  to  acceptance  but  in  addition  in- 
volving wanting  to  do  something  for  others  is  the  mechanism 
of  altruism.  The  essence  of  this  mechanism  is  the  desire  to 
|help  others  (p.  107). 

re  these  two  mechanisms  so  salient  because  the 
au^ors  of  the  works  thus  analyzed  have  a  basically 
religious  orientation?  Or  have  the  authors,  with  an 
initially  neutral  or  perhaps  even  unsympathetic  attitude, 
empirically  rediscovered  the  therapeutic  potency  of  ''fel- 
lowship" and  "charity"? 

Whatever  the  answer  to  this  question,  the  fact  stands 
out  that,  increasingly,  psychologists  are  joining  psychia- 
trists and  clergymen  in  looking  for  both  the  cause  and 
cure  of  personality  difficulties  in  the  social,  interpersonal, 
moral,  or  "spiritual"  realm.  But  what  of  those  most 
welcome  advances  recently  made  in  drug  therapy?  As 
May  (1955)  has  cogently  observed,  these  drugs — merciful 
as  they  are  for  use  with  persons  in  terror  states  and  agita- 
tions— leave  essentially  untouched  the  problem  of  pre- 
vention and  personality  reorganization. 

In  our  neighbor  discipline.  Sociology,  there  has  long 
been  a  tendency  to  view  mind,  or  "self,"  as  much  more 
of  a  social  than  biological  phenomenon.  Here  the  influ- 
ence of  Mead  (1934)  is  already  strong,  and  becoming 
increasingly  so.  Thus  the  confluence  of  thought  noted 
above  gains  yet  another  tributary. 

The  centrality  of  religious  tradition  and  practice  is 
obvious  here.  But  there  was  a  manifest  difficulty.  Let  one 
highly  placed  within  organized  religion,  itself,  speak  on 
this  score.  Says  Rev.  James  A.  Pike  (1954),  Dean  of  the 
Episcopal  Cathedral  of  St.  John  the  Divine,  in  New 
York: 


14  The  Crisis  in  Psychiatry  and  Religion 

The  Biblical  writers  are,  by  and  large,  short  on  concepts, 
long  on  concern  as  to  the  human  situation.  The  early  Church 
carried  this  tradition  forward:  the  articles  of  the  Creeds  are 
not  just  intellectual  speculations.  They  are  affirmations 
wrought  out  in  the  fire  of  personal  and  corporate  experience 
and  found  to  be  abiding  answers  to  perennial  questions 
which  affect  the  nature  and  direction  of  human  life  under 
God  (p.  6). 

The  Biblical  writers  emphasize,  not  "theory,"  but 
testimony.  Make  an  "investment,"  "experiment,"  "try  it" 
say  characters  in  Lloyd  Douglas'  novels.  Or,  in  Pike's  own 
colorful  phrase,  in  order  to  find  out  you  have  to  "bet  your 
life."  Prove  all  things,  said  the  Apostle,  Paul.^  Perhaps 
psychologists  can  ultimately  help  provide  a  clearer,  more 
naturalistic,  more  rational  explanation  and  understanding 
of  these  pragmatic  varieties.  This  would  be  an  undertak- 
ing of  first-rate  importance  and  magnitude.  But  before 
psychologists  and  religionists  can  thus  creatively  collab- 
orate, both  must  change  from  what  they  have  earlier 
been.  Contemporary  religious  writers  now  seem  increas- 
ingly aware  of  errors  into  which  religion  fell  during  the 
nineteenth  century.  One  of  these  errors  was  obstinacy  in 
accepting  the  clear  evidence  for  organic  evolution.  But 
ever  more  grievous,  perhaps,  was  a  later  willingness  to  go 
too  far  in  accepting  the  psychological  view  of  man 
seemingly  dictated  by  evolutionary  considerations.  In  the 
introduction  to  Alexander  Miller's  recent  book,  The 
Renewal  of  Man,  Reinhold  Niebuhr  (1955)  has  said: 

Christianity  has  tried  rather  too  desperately  to  accom- 
modate itself  to  modernity.  In  its  desperation  it  frequently 
sacrificed  just  those  points  in  the  Christian  Gospel  which 
would  throw  light  on  mysteries  which  modern  learning  left 
obscure  (p.  8). 

The  present  age,  though  incredulous  toward  the  chief  af- 
firmations of  this  faith,  is  bound  to  find  it  more  relevant 
than  previous  ages,  which  conceived  their  own  schemes  of 
salvation.  Our  age  is  the  inheritor  of  the  confusion  and  the 
evil  which  proceeded  precisely  from  these  schemes  of  salva- 
tion (p.  9). 

'^Walters  (1955)  has  pertinently  observed  that  Freud, 
while  condemning  religion,  took  the  same  position  in 
holding  that  no  one  could  properly  evaluate  or  criticize 
psychoanalysis  who  had  not  himself  had  such  an  expe- 
rience. 


Philosophical  Problems  in  Counseling  15 

There  are  many  indications,  over  and  beyond  those 
cited  in  this  paper,  that  we  are  now  well  into  a  religious 
reformation  comparable  in  scope  and  significance  to  that 
of  four  hundred  years  ago.  Institutionalized  religion  had 
stagnated.  Within  the  past  century,  science  in  general 
and  biological  science  in  particular,  threatened  its  very 
life.  Now  religion  appears  to  be  recovering  and,  in  that 
process,  has  gained  new  vitality  and  validity.  What  are 
the  implications  of  this  unexpected  turn  of  events  for 
psychology?  Although  we  may  feel  uncertain  of  the 
answer,  we  cannot  complacently  ignore  the  question. 


^ 


SUMMARY 


There  is  clear  indication  that  the  theory  of  organic  evo- 
lution has  profoundly  and  pervasively  influenced  American 
psychology  during  the  past  three-quarters  of  a  century. 
Mind,  rather  than  being  something  to  be  studied  in  its 
own  right,  has  been  conceived  as  "an  organ  of  adapta- 
tion," an  appendage  of  the  body  instrumental  to  the 
achievement  of  bodily  ends. 

Thanks  to  the  stance  of  the  "New  Psychology"  (Func- 
tionalism.  Behaviorism),  it  has  proved  possible,  for  the 
first  time,  to  develop  a  systematic,  essentially  objective 
understanding  of  many  basic  psychological  processes. 
Behavior  theory  is  now  a  relatively  unified  assembly  of 
fact  and  principle  which  commands  respect  in  any  scien- 
tific company. 

Nor  was  the  influence  of  Darwinian  thought  restricted 
to  psychology  in  this  country.  Equally  potent  was  its 
impact  upon  Freud  and  the  school  of  psychopathology 
which  he  founded.  Here  the  "neuroses,"  both  mild  and 
severe,  were  seen  as  springing  from  the  fact  that  the 
mind,  under  the  sway  of  unfortunate  or  misdirected 
social  experience,  has,  in  effect,  turned  against  the  body 
and  is  no  longer  ministering  to  its  needs. 

But  there  is  increasing  evidence  that  neither  the 
original  Freudian  formulation  nor  its  attempted  restate- 
ment in  terms  of  contemporary  behavior  theory  gives  us 
the  answer  to  some  of  man's  most  profound,  and  uniquely 
human,  problems.  Today  we  are  probing  the  future 
(through  research)  and  searching  the  past,  through 
historical  studies,  for  leads  to  a  better  and  psychologically 


16  The  Crisis  in  Psychiatry  and  Religion 

more  abundant  life.  What  do  we  find?  Growing  indica- 
tion that  the  human  mind,  in  its  towering  complexity^ 
long  ago  reached  the  point  where  it  has  its  own  special 
conditions  for  ''survival/'  conditions  which  are  not  only 
different  from  those  of  physical  comfort  and  well-being 
but  which  may  on  occasion  be  in  conflict  therewith. 
Both  ongoing  researches  and  a  re-examination  of  history 
point  to  the  conclusion  that  religious  precepts  and  prac- 
tices, over  the  centuries,  have  grown  up  largely  in  response 
to  man's  unique  psychological  needs  and  that  there  are 
insights  and  prescriptions  for  action  here  which  con- 
temporary man  may,  with  profit,  reconsider. 

Such  a  reconsideration  seems  now  to  be  well  under 
way,  mainly  by  theologians,  naturally  enough,  but  also, 
and  to  a  surprising  degree,  by  psychiatrists.  Psychologists, 
in  their  increasing  interest  in  group  psychotherapy,  are 
also  showing  a  new  awareness  of  social  values;  and  several 
interprofessional  groups  have  recently  been  formed  for  a 
concerted  confrontation  of  the  problem  at  the  level  of 
research  and  practice. 

The  burden  of  the  present  paper  is  that  it  will  greatly 
hasten  this  readjustment  if  we  can  succeed  in  seeing  the 
proper  relationship  between  man's  needs  for  physical 
and  psychological  survival  and  can  transcend  the  tacit 
assumption  that  mind  is  merely  servant  of  the  body  and 
that,  if  it  serves  this  master  well,  it  will  itself  neces- 
sarily prosper.  Long  ago  we  were  reminded  that  man 
does  not  live  by  bread  alone;  and  it  is  none  too  early 
for  us  to  turn  our  attention  to  the  identification  and 
better  understanding  of  this  ''something  more." 


Changing  Conceptions 
of  the  Unconscious* 

Perhaps  more  than  anything  else,  the  feature  of  Freud- 
ian psychoanalysis  which  has  given  it  an  air  of  mystery 
and  its  practitioners  a  presumption  of  esoteric  knowledge 
and  power  is  its  doctrine  of  ''The  Unconscious."  In  the 
present  chapter  we  see  that  this  doctrine  is  in  process  of 
radical  revision  and  re-evaluation,  along  lines  more  con- 
genial to  common  sense  and  traditional  moral  and  reli- 
gious ideology.  Now  it  is  possible,  in  terms  of  this  evolv- 
ing conception  of  psychopathology,  for  the  average  per- 
son not  only  to  know  something  about  such  matters  but 
also  to  do  something,  i.e.,  take  initiative  and  responsibility 
in  their  prevention  and  correction. 

In  the  preceding  chapter,  we  have  postulated  that  per- 
sonality disturbance  can  be  adequately  understood  only 
in  an  interpersonal,  social,  moral  matrix.  But  in  order  for 
this  conception  to  hold,  we  must  also  be  able  to  account 
for  the  purely  internal,  intrapsychic — as  well  as  external, 
interpersonal — phenomena  which  characterize  those 
states  we  call  neurosis  and  psychosis.  The  critical  con- 
sideration here  is  the  way  in  which  that  remarkable 
agency  known  as  conscience  operates.  If  our  present 
analysis  is  correct,  personality  disturbance  is  less  an  ''ill- 
ness'' than  an  effort,  on  the  part  of  "The  Unconscious," 
to  bring  about  personal  change  and  growth.  Can  it  be 
that  much  of  our  current  therapeutic  and  preventive 
endeavor  in  this  area  is  ineffective  {even  harmful)  be- 
cause it  is  predicated  on  a  contrary  set  of  assumptions? 

INTRODUCTION 

In  a  field  which  otherwise  abounds  with  confusion  and 
uncertainty,  there  is  one  rock-ribbed  fact:  namely,  that 
the  hallmark  of  psychopathology  is  a  feeling,  on  the  part 
of  the  afflicted  individual,  that  he  is  having  experiences 

17 


18  The  Crisis  in  Psychiatry  and  Religion 

which  he  himself  did  not  plan  or  "will"  and  which  he 
does  not  at  all  understand.  The  ubiquity  of  this  observa- 
tion, therefore,  makes  entirely  plausible  the  impression 
that  personality  disturbance  is  somehow  associated  with 
the  presence  and  activity  of  an  alien,  dissociated,  un- 
known, and  ominous  force  or  set  of  forces  within  the 
personality  which  is  currently  known  as  The  Unconscious,  j 
But  beyond  this  point,  there  is  scant  agreement.  What 
is  in  the  Unconscious?  How  did  it  get  there?  What  is  it 
trying  to  do?  Should  it  be  assisted  or  opposed?  These 
are  questions  to  which,  in  our  time,  we  have  had  no 
assured  answers.  The  purpose  of  the  present  paper  is  to 
look  at  these  questions  and  at  the  overall  problem  of  psy- 
chopathology  in  historical  perspective  and  to  suggest,  ten- 
tatively, a  way  of  reinterpreting  and,  hopefully,  integrat- 
ing the  presently  discordant  array  of  fact,  theory,  and 
practice. 

FREUD   ON  REPRESSION  AND  THE  UNCONSCIOUS 

From  the  point  of  view  of  this  inquiry,  1915  was  an 
eventful  year.  In  that  year  Freud  published  two  papers, 
one  on  ''Repression"  and  the  other  on  'The  Uncon- 
scious" which  epitomized  his  theoretical  system  or  so- 
called  "metapsychology"  and  which  set  forth  ideas  that 
have  gained  world-wide  currency  and  influence.  In  the 
second  of  these  papers,  Freud  argued  persuasively  that 
the  concept  of  mind  or  mental  activity  should  not  be 
confined  to  those  processess  which  are  at  any  given  mo- 
ment conscious  or  likely  to  become  conscious,  but  should 
instead  include  forces  or  processes  which  are  unconscious 
but  which  are  not,  for  that  reason,  to  be  thought  of  as 
dormant  or  ineffectual  in  determining  experience  and 
action.  He  said: 

In  many  quarters  our  justification  is  disputed  for  assuming 
the  existence  of  an  unconscious  system  in  the  mind  and 
for  employing  such  an  assumption  for  purposes  of  scientific 
work.  To  this  we  can  reply  that  our  assumption  of  the 
existence  of  the  unconscious  is  necessary  and  legitimate,  and 

*  Prepared  and  delivered,  by  invitation,  as  a  lecture  at  the 
1958  meeting  of  the  American  Personnel  and  Guidance  Asso- 
ciation, in  St.  Louis,  and  subsequently  published  in  The  Jour- 
nal of  Nervous  and  Mental  Diseases,  1959,  129,  222-232. 


Changing  Conceptions  of  the  Unconscious       19 

that  we  possess  manifold  proofs  of  the  existence  of  the  un- 
conscious. It  is  necessary  because  the  data  of  consciousness 
are  exceedingly  defective;  both  in  healthy  and  in  sick  persons 
mental  acts  are  often  in  process  which  can  be  explained  only 
by  presupposing  other  acts,  of  which  consciousness  yields  no 
evidence.  These  include  not  only  the  parapraxes  and  dreams 
of  healthy  persons,  and  everything  designated  a  mental 
symptom  or  an  obsession  in  the  sick;  our  most  intimate  daily 
experience  introduces  us  to  sudden  ideas  of  the  source  of 
which  we  are  ignorant,  and  to  results  of  mentation  arrived  at 
we  know  not  how.  All  these  conscious  acts  remain  discon- 
nected and  unintelligible  if  we  are  determined  to  hold  fast 
to  the  claim  that  every  single  mental  act  performed  within 
us  must  be  consciously  experienced;  on  the  other  hand,  they 
fall  into  a  demonstrable  connection  if  we  interpolate  the 
unconscious  acts  that  we  infer.  .  .  .  We  become  obliged 
then  to  take  up  the  position  that  it  is  both  untenable  and 
presumpfeious  to  claim  that  whatever  goes  on  in  the  mind 
must  be  known  to  consciousness  (1915b,  p.  99). 

While  Freud  did  not  hold  that  the  unconscious  mind 
is  created  solely  by  repression,  he  did  hold  that  repression 
is  a  potent  source  of  unconscious  energies  and  a  prime 
cause  of  psychopathology.  The  mere  fact  that  an  idea 
or  impulse  has  been  banished  from  consciousness  does 
not  at  all  mean  that  it  has  lost  its  dynamic  properties; 
and  its  continued  striving  for  recognition  and  expression 
constitutes,  according  to  Freud,  the  principal  basis  of 
anxiety  and  ensuing  symptom  formation.  More  specifically 
Freud  believed  that  the  mental  processes  which  are  most 
likely  to  undergo  repression  are  the  instinctual  forces  of 
sexuality  and  hostility  and  that  repression  occurs,  typi- 
cally, v^^hen  the  ego,  under  the  sway  of  socially  instilled 
moral  precepts,  rejects  and  condemns  these  impulses. 

Two  forms  or  stages  of  repression  were  to  be  distin- 
guished. There  was,  first  of  all,  what  Freud  called  primal 
repression^  *'a  first  phase  of  repression,  which  consists  in 
a  denial  of  entry  into  conscious  of  the  mental  (idea- 
tional) presentation  of  the  instinct"  (1915a,  p.  86).  But, 
continued  Freud,  "repression  does  not  hinder  the  instinct- 
presentation  from  continuing  to  exist  in  the  unconscious 
and  from  organizing  itself  further,  putting  forth  deriva- 
tives and  instituting  connections"  (p.  87). 

The  second  phase  of  repression,  repression  proper,  con- 
cerns mental  derivatives  of  the  repressed  instinct-presentation, 


20  The  Crisis  in  Psychiatry  and  Religion 

or  such  trains  of  thought  as,  originating  elsewhere,  have 
come  into  associative  connection  with  it.  On  account  of  this 
association,  these  ideas  experience  the  same  fate  as  that 
which  underwent  primal  repression.  Repression  proper,  there- 
fore, is  actually  an  after-expulsion  (pp.  86-87). 

Therefore,  continued  Freud, 

The  process  of  repression  is  not  to  be  regarded  as  some- 
thing which  takes  place  once  for  all,  the  results  of  which 
are  permanent,  as  when  some  living  thing  has  been  killed 
and  from  that  time  onward  is  dead;  on  the  contrary,  repres- 
sion demands  a  constant  expenditure  of  energy,  and  if  this 
were  discontinued  the  success  of  the  repression  would  be 
jeopardized,  so  that  a  fresh  act  of  repression  would  be  neces- 
sary. We  may  imagine  that  what  is  repressed  exercises  a  con- 
tinuous straining  in  the  direction  of  consciousness,  so  that  the 
balance  has  to  be  kept  by  means  of  a  steady  counter-pressure. 
A  constant  expenditure  of  energy,  therefore,  is  entailed  in  1 
maintaining  a  repression,  and  economically  its  abrogation 
denotes  a  saving  (pp.  89-90). 

The  resolution  of  a  conflict  between  instinct  and  moral 
scruple  by  means  of  repression  is  thus  unstable  and  debil-  ^ 
itating;  and  from  this  it  followed,  reasonably  enough, 
that  the  sovereign  aim  of  therapy  was  to  undo  repression 
and  permit  sexual  and  hostile  impulses  to  find  freer,  less 
encumbered  routes  to  gratification.  Such  a  program  called 
upon  the  psychoanalyst  to  align  himself  with  and  to  speak 
for  the  instincts,  in  opposition  to  the  moral  or  pseudo- 
moral  forces  within  the  personality  which  have  instituted 
the  repression.  Hopefully,  these  forces  can  be  held  back 
by  the  combined  strength  of  the  patient  and  the  analyst 
so  that  the  blocked  instincts  can  find  more  adequate  ex- 
pression; and,  more  than  this,  it  was  believed  that,  by 
working  through  the  so-called  transference  neurosis,  the 
severity  and  irrationality  of  these  forces  might  be  perma- 
nently lessened  so  that,  following  analysis,  the  individual 
could  function,  more  naturally  and  more  comfortably, 
without  the  analyst's  continued  presence  or  assistance. 

For  all  practical  purposes,  Freud's  theory  was  here- 
with complete.  In  the  1915  papers  he  still  regarded  anx- 
iety as  a  direct  "transformation"  of  the  repressed  im- 
pulses, a  view  which  was  to  be  somewhat  modified  in  his 
"second  theory"  of  anxiety.  And  he  was  still  to  introduce 
the  term,  superego,  although  he  was  already  speaking  of  a 


Changing  Conceptions  of  the  Unconscious        21 

"censorship"  function  (1915b,  p.  105).  But,  in  broad 
outline  at  least,  the  theory  was  fully  developed  and  was 
later  to  be  changed  in  only  minor  ways.  With  his  special 
gift  for  graphic  similes,  Freud  summarized  his  discussion 
of  repression  thus: 

In  general,  repression  of  an  instinct  can  surely  only  have 
the  effect  of  causing  it  to  vanish  from  consciousness  if  it  had 
previously  been  in  consciousness,  or  of  holding  it  back  if  it 
is  about  to  enter  it.  The  difference,  after  all,  is  not  impor- 
tant; it  amounts  to  much  the  same  thing  as  the  difference 
between  ordering  an  undesirable  guest  out  of  my  drawing- 
room  or  out  of  my  front  hall,  and  refusing  to  let  him  cross 
my  threshold  once  I  have  recognized  him  (1915a,  p.  91). 

To  which  we  need  only  add  that  the  unwelcome 
"guest"  does  not,  after  his  ejection,  quietly  go  away,  but 
instead  continues  to  try  to  find  other  means  of  re-entry 
and,  much  in  the  manner  of  a  restless  ghost,  haunts  the 
abode  which  it  feels  to  be  rightfully  its  own,  to  the  dis- 
may and  discomfiture  of  the  dominant  occupant. 

THE^  ALTERNATIVE   VIEW 

OF   STEKEL,   BOISEN  AND   OTHERS 

In  his  recently  published  three-volume  biography, 
Ernest  Jones  defends  Freud  against  the  common  surmise 
that  he  was  a  difficult  man  to  get  along  with  and  argues 
that  those  who  were  first  attracted  to  but  then,  sooner  or 
later,  turned  against  him  were  themselves  unstable  or  of 
doubtful  character.  On  the  other  hand,  Ira  Progoff,  in 
his  book  The  Death  and  Rebirth  of  Psychology,  suggests 
that  the  difficulty  was  not  basically  one  of  ''personality" 
at  all,  on  either  side,  but  was  rather  ideological.  At  least 
in  the  case  of  Adler,  Jung  and  Rank  the  final  rupture, 
Progoff  holds,  came  because  these  men  were  keenly  aware 
of  incongruities  between  the  clinical  facts  and  Freud's 
theories  and  were  compelled  to  withdraw  from  the  orbit 
of  his  influence  in  order  to  be  true  to  their  own  develop- 
ing ideas  and  convictions  [cf .  Chapter  1 3] . 

Among  the  less  well  known  but  most  interesting  of 
those  men  who  first  joined  and  then  left  Freud  was 
Wilhelm  Stekel.  In  his  autobiography,  published  in  1950, 
Stekel  gives  the  details  of  his  break  with  Freud,  over  ap- 
parently personal  and  practical  matters;  but  a  study  of 


22  The  Crisis  in  Psychiatry  and  Religion 

StekeFs  other  published  works  reveals  a  deep  and,  for  our 
purposes,  highly  significant  theoretical  deviation. 

In  the  preface  of  a  book  first  published  in  German 
(1938)  and  later  translated  into  English  (1950),  with 
the  title  Technique  of  Analytical  Psychotherapy,  Stekel 
indicated  just  how  complete  his  break  with  Freud  had 
been  by  remarking: 

I  contend  that  orthodox  analysis  has  reached  a  crisis  which 
betokens  that  the  end  is  near,  that  collapse  is  approaching. 
Clinical  records  of  its  successes  count  for  nothing,  now.  The 
happy  days  of  interminable  analyses  are  gone  for  ever  (p. 
xxii ) } 

The  medical  analysis  of  tomorrow  will  have  to  separate 
the  wheat  from  the  chaff,  to  combine  the  various  doctrines 
and  schools  into  an  organic  whole,  and  to  establish  an  un- 
dogmatic,  unprejudiced  psychoanalysis.  Then  the  physician 
will  become  the  educator  of  mankind  (p.  xxiv). 

The  seemingly  hasty  and  bombastic  way  in  which 
Stekel  wrote  undoubtedly  kept  him  from  being  taken  as 
seriously  as  he  otherwise  might  have  been;  but  in  light  of 
subsequent  developments,  we  find  a  genuinely  prophetic 
element  in  his  work.  In  Technique  of  Analytical  Psy- 
chotherapy there  is  a  most  remarkable  chapter  entitled 
''Diseases  of  the  Conscience"  which  does  not  unfold  at 
all  the  way  one  might  expect  it  to.  Freud — implicitly  in 
his  early  writings  and,  later  on,  quite  explicitly — ^held 
that  repression,  as  the  primal  pathogenic  act,  occurs  be- 
cause the  individual's  conscience  or  superego  is  too  severe, 
unrealistic,  and  irrational.  Therefore,  when  Stekel  refers 
to  "diseases  of  consciences,"  one  might  well  expect  him 
to  have  in  mind  much  the  same  assumptions  as  had 
underlain  Freud's  conception  of  the  so-called  neuroses. 

Instead,  Stekel's  attitude  toward  conscience  is  respectful 
and  positive;  and  by  ''diseases  of  conscience"  it  is  quickly 
apparent  that  he  means  diseases  or  disturbances  which 
are  caused  by  a  careless  disregard  or  active  defiance  of 
conscience  and  its  urgings.  He  says: 

My  experiences  as  a  psychotherapist  have  convinced  me 
that  many  nervous  disorders  are  "diseases  of  the  conscience." 
Of  course  it  is  far  from  easy  to  recognize  conscience  under 

*  Cf .  Freud's  own  paper,  "Analysis  terminable  and  intermin- 
able" (1937). 


Changing  Conceptions  of  the  Unconscious       23 

the  manifold  disguises  it  can  assume.  But  there  are  stereo- 
typed ways  by  which  we  can  be  aided  in  exposing  the  wiles 
of  conscience,  and  in  discovering  when  parapaths  are  play- 
acting— for  they  often  persuade  themselves  that  they  have 
no  conscience,  and  take  refuge  in  an  ostensibly  organic 
disease  in  order  to  escape  the  torment  of  self-reproach.  Some- 
times, however,  such  a  patient  will  during  the  analysis  have 
a  bad  "fit  of  conscience,"  bursting  into  tears,  which  may 
continue  for  as  much  as  half  an  hour  before  the  releasing 
avowal  comes  (p.  320). 

Stekel,  as  was  his  literary  practice,  then  plunges  into  a 
series  of  interesting  and  highly  dramatic  case  histories 
which  we  cannot  review  here.  But  in  summary  he  says: 

All  these  cases  show  how  grave  a  blunder  we  should  make 
were  we  to  accept  the  one-sided  view  of  those  Freudians  who 
hold  that  lack  of  sexual  gratification  is  the  exclusive  cause  of 
psychogenic  troubles.  In  Cases  69,  70,  and  71,  free  rein  was 
given  to  the  sexual  impulse,  which  was  adequately  gratified, 
and  yet  intractable  illness  supervened,  whereas  during  the 
periods  of  abstinence  the  symptoms  disappeared  because  the 
conflict-engendering  relations  were  broken  off  and  the  con- 
science was  at  rest  (p.  324). 

I  have  had  many  cases  of  the  kind,  but  have  merely 
selected  a  few  to  show  that  parapathic  disorders  may  be 
diseases  of  the  conscience.  The  patient  suppresses  his  re- 
morse, tries  to  drown  the  voice  of  conscience,  and  feigns 
immunity.  Nature  takes  vengeance  (p.  327). 

As  long  as  Freudian  theory  was  in  the  ascendancy,  it  is 
little  wonder  that  Stekel's  views  remained  unknown  and 
without  influence.  But  in  1956  a  book  entitled  Progress 
in  Psychotherapy  was  published  in  this  country  (under 
the  semi-official  auspices  of  the  American  Psychiatric  As- 
sociation) in  which  many  of  the  forty-odd  contributors 
expressed  mounting  doubt  and  disillusionment  concern- 
ing orthodox  psychoanalysis  and  in  which  there  is  a 
chapter,  by  Lowy  and  Gutheil,  which  is  devoted  to  an  ex- 
position and  advocacy  of  Stekel's  so-called  "active  ana- 
lytic" approach  to  psychotherapy.  Here  these  authors  say: 

Stekel's  debut  as  the  originator  of  an  independent  psy- 
choanalytic technique  was  manifested  by  his  thesis  that  every 
<  neurosis — or  as  he  called  it  "parapathy" — is  based  on  a  con- 
Iflict  between  the  principles  of  morality  and  loyalty  and  the 
impulses  and  tendencies  to  the  contrary.  This  simple,  clini- 


24  The  Crisis  in  Psychiatry  and  Religion 

cally  evolved  formula  was  then  not  as  self-evident  as  it  has 
become  subsequently.  .  .  . 

Although  essentially  a  practitioner,  Stekel  also  made  a  few 
important  contributions  to  the  theory  of  psychoanalysis.  Long 
before  Freud's  discovery  of  the  superego,  Stekel  spoke  of  the 
-'moral  ego"  as  a  factor  in  the  psychogenesis  of  neurosis.  He 
//maintained   that   a   neurotic   reaction   can   ensue   not   only 
i  through  the  repression  of  moral  tendencies;  that  on  certain 
*•  occasions,  even  if  the  individual  appears  to  be  ready  to  give 
/  in  to  his  antimoral  and  antisocial  desires,  the  moral  trends 
I    may  assert  themselves  against  the  patient's  will.  He  [Stekel] 
quoted  the  case  of  a  traveling  salesman  who  was  always 
potent   with   his   wife,   while   being   impotent   with    other 
women.    Cases   of   this   type   were    considered   proofs   that 
neurotic  symptoms  may  be  serving  the  patient's  unconscious 
moral  needs,  that  they  may  safeguard  the  individual's  in- 
trinsic morality  (p.  136). 

As  ProgofI  points  out  in  the  book  previously  cited, 
Adler,  Jung  and  Rank,  in  abandoning  the  classical  psy- 
choanalytic position,  all  moved  in  the  direction  of  a 
greater  emphasis  upon  the  social,  moral,  or  ''spiritual" 
factors  in  neurosis;  but  this  trend  was  certainly  outstand- 
ing in  Stekel,  as  the  foregoing  quotations  indicate. 

Also,  about  the  same  time  and  apparently  quite  inde- 
pendently of  any  direct  connection  v^ith  Stekel,  an 
American  writer  by  the  name  of  Anton  T.  Boisen  was 
formulating  a  very  similar  point  of  view.  As  a  result  of  a 
brief  psychotic  experience  of  his  own  and  of  subsequent 
participation  in  the  Rockefeller-supported  study  of  schizo- 
phrenia at  the  Worcester  (Massachusetts)  State  Hos- 
pital, Boisen  became  convinced  that  psychosis  represents 
a  character  crisis,  from  which  an  individual  may  move 
either  in  the  direction  of  deterioration  or  toward  personal 
reorganization  on  an  ethically  and  socially  higher  plane. 
Gentle,  soft-spoken,  and  in  no  sense  given  to  controversy, 
Boisen  was  temperamentally  very  different  from  Stekel, 
yet  his  ideas  about  psychopathology  are  much  the  same. 
In  his  best  known  book.  The  Exploration  of  the  Inner 
World  (1936),  Boisen's  views  are  epitomized  by  the  fol- 
lowing excerpts.  He  says: 

The  form  of  psychotherapy  now  most  in  the  public  eye  is 
psychoanalysis.  This  in  its  aims  is  the  exact  opposite  of 
faith  healing.  It  has  often  been  compared  by  its  proponents 
to  surgery,  and  major  surgery  at  that.  It  is  an  attempt  to 


Changing  Conceptions  of  the  Unconscious       25 

lay  bare  and  bring  into  clear  consciousness  the  disowned 
sexual  desires  and  cravings  which  it  assumes  have  become 
detached  from  the  conscious  self  and  are  responsible  for  the 
neurotic  symptoms.  Its  aim  is  to  make  over  the  harsh  con- 
science and  the  rigid  ethical  standards  which  have  led  to  the 
disowning  of  these  sex  cravings  so  as  to  permit  of  their  in- 
corporation in  the  personality.  To  this  end  the  psychoanalyst 
tries  to  get  his  patient  to  live  through  again  his  early  ex- 
periences. The  entire  procedure  is  designed  to  detach  the 
patient  from  his  early  loyalties  in  order  to  enable  him  to 
build  up  a  new  philosophy  of  life  in  which  the  dissociated 
cravings  may  be  properly  assimilated  (pp.  243-244). 

In  all  my  efforts  [as  a  hospital  chaplain  and  therapist]  I 

rely  upon  a  simple  principle   derived  from   my  theological 

training  which  seems  to  me  far  too  little  understood.  I  refer 

jto  the  view  that  the  real  evil  in  mental  disorder  is  not  to  be 

\found  in  the  conflict  but  in  the  sense  of  isolation  or  estrange- 

\ment.  It  is  the  fear  and  guilt  which  result  from  the  presence 

iin  one's  life  of  that  which  one  is  afraid  to  tell.^  For  this 

reason  I  do  not  consider  it  necessary  to  lower  the  conscience 

threshold  in  order  to  get  rid  of  the  conflict.  What  is  needed 

is  forgiveness  and  restoration  to  the  fellowship  of  that  social 

something  which  we  call  God  (pp.  267-268). 

I  would  furthermore  [suggest]  that  our  findings  indicate 
that  the  sense  of  guilt,  the  self-blame  and  the  emotional  dis- 
turbance which  accompany  it  are  not  themselves  evils  but 
atteijipts  at  a  cure.  The  real  evil  is  the  failure  to  attain  the 
level  of  adjustment  called  for  in  some  new  period  of  develop- 
ment and  the  short-circuiting  of  the  vital  energies  through 
;  easy  satisfaction  (p.  281). 

Elsewhere  in  the  same  volume  Boisen,  using  a  phrase- 
ilogy  almost  exactly  the  same  as  Stekel's,  refers  to  a 
everely  neurotic  or  psychotic  person  as  one  who  ''has 
ecourse  to  certain  unsatisfactory  protective  devices,  seek- 
ng  to  suppress  a  troublesome  conscience,  until  the  ten- 
ion  reaches  the  breaking  point  and  the  solution  comes 
i^ith  cataclysmic  suddenness"  (p.  78). 

Only  vaguely  aware  of  the  names  of  Stekel  and  Boisen 
nd  without  any  detailed  familiarity  with  their  writings, 
he  present  writer,  in  1947,  after  more  than  a  decade  of 
icceptance  of  the  Freudian  view,  took  the  following  posi- 
ion: 

^  Somewhere  I  have  recently  read  that  Havelock  Ellis,  even 
:arlier,  once  remarked  that  the  problem  of  psychopathology 
irises,  not  from  the  unconscious,  but  from  the  unutteredl 


26  The  Crisis  in  Psychiatry  and  Religion 

By  way  of  recapitulation  let  it  be  said  that  we  are  here 
fully  accepting  the  basic  theory  of  Freud  concerning  the  na- 
ture of  symptom  formation,  i.e.,  that  a  neurotic  symptom, 
so-called,  is  any  habit  which  resolves  anxiety  but  does  not ; 
lessen  the  ultimate,  realistic  problem  which  the  anxiety  repre- 
sents. And  we  are  also  in  complete  accord  with  Freud's  con- 
tention that  repression  is  necessary  to  an  adequate  theory  of 
anxiety;  without  this  concept  a  really  satisfactory  account  of:' 
anxiety  is  apparently  quite  impossible.  But  it  now  appears,  onjl 
both  pragmatic  and  logical  groups,  that  Freud  never  suc- 
ceeded in  fully  apprehending  the  essential  nature  of  anxiety ' 
itself. 

It  is  not  possible  at  this  time  to  give  at  all  completely  the  J 
evidence  on  which  this  statement  is  based.  But  what  can  be;' 
/  j     indicated,  at  least  briefly,  is  the  direction  in  which  Freud's 
/  !    analysis  needs  to  be  modified.   In  essence,  Freud's  theory 
holds  that  anxiety  comes  from  evil  wishes,  from  acts  which , 
the  individual  would  commit  if  he  dared.  The  alternative 
view  here  proposed  is  that  anxiety  comes,  not  from  acts 
which  the  individual  would  commit  but  dares  not,  but  from 
acts  which  he  has  committed  but  wishes  that  he  had  not.  It 
is,  in  other  words,  a  ''guilt  theory"  of  anxiety  rather  than  an 
"impulse  theory." 
^  Stated  in  its  most  concise  but  abstract  form,  the  diflFerence 

'^^  between  these  two  views  is  that  the  one  holds  that  anxiety 
arises  from  repression  that  has  been  turned  toward  the  id; 
whereas  the  other  holds  that  anxiety  arises  from  repression, 
that  has  been  turned  toward  the  superego  or  conscience  (p. 
537). 

Naturally,  the  later  discovery  of  the  antecedent  works 
of  Stekel  and  Boisen  and  the  privilege  of  personal  ac- 
quaintance with  Dr.  Boisen  have  been  a  source  of  great 
personal  satisfaction  to  the  writer.  But,  despite  the  con- 
verging agreements  to  be  found  here  and  elsewhere  in 
contemporary  literature,  some  conceptual  difficulties  are 
still  to  be  resolved.  These,  it  so  happens,  have  been 
neatly  summarized  by  Sidney  M.  Jourard  in  his  book. 
Personal  Adjustment — An  Approach  Through  the  Study 
of  Healthy  Personality.  Here  the  author  says: 

Clinical  experience  suggests  that  neither  Freud  nor  Mowrer 
is  wholly  correct  or  wholly  incorrect.  Rather,  it  can  be 
found  that  some  neurotic  patients  do  indeed  have  a  con- 
science that  is  too  strict;  in  order  to  remain  guilt-free,  they 
must  refrain  from  all  pleasurable  activities,  including  those 
which  society  condones.  Other  patients  may  be  found  with 


Changing  Conceptions  of  the  Unconscious        27 

the  makeup  which  Mowrer  has  regarded  as  nuclear  to  all 
neurosis — they  repress  conscience  so  they  can  break  social 
tabooes  without  conscious  guilt. 

If  we  paraphrase  Freud's  therapeutic  aim  to  read,  "change 
the  conscience  in  lenient  directions,"  and  Mowrer's  to  read, 
"strengthen  the  conscience,  and  help  the  person  to  conform 
with  his  conscience,"  we  are  thrust  into  an  acute  impasse:  we 
find  that  contradictory  roles  are  assigned  to  the  conscience  in 
neurosis,  and  contradictory  therapeutic  aims  are  proposed. 
This  impasse  can  be  resolved  if  we  recognize  that  consciences 
are  not  all  alike  among  all  members  of  a  given  society.  Some 
consciences  are  stricter  than  the  society  requires,  some  are 
more  lenient,  some  are  quite  deviant  from  the  social  value 
system,  and  many  are  highly  conflicted  (p.  366).* 

This  analysis  seems  by  no  means  unreasonable.  It  does 
lot,  however,  accurately  represent  my  own  earlier  posi- 
:ion  in  these  matters,  in  that  never  did  I  hold  that  it  was 
:he  aim  of  therapy  to  strengthen  or  increase  the  severity 
)f  the  conscience,  although  this  has  been  a  common 
nispreception.  All  I  had  said  was  that  perhaps  the  neuro- 
:ic's  great  need  was  to  have  his  conscience  released^  just 
IS  Freud  had  conjectured  that  it  was  certain  repressed 
nstincts  that  were  clamoring  for  freer  access  to  con- 
leiousness  and  a  greater  share  in  the  control  of  behavior. 
[n  neither  case  was  it  suggested  or  even  implied  that  the 
repressed  part  of  the  personality  needed  to  be  strength- 
zned.  Because  Freud  did  hold  that  the  neurotic's  superego 
[leeded  to  be  made  less  rigid  and  less  severe;  and  because 
[  had  expressed  a  disagreement  with  this  position,  it  was 
m  easy  but  entirely  mistaken  inference  that  I  was  saying 
just  the  reverse  of  this.  My  difference  with  Freud's  posi- 
tion had  to  do,  explicitly  and  exclusively,  with  the  ques- 
tion of  what  is  repressed  or,  in  other  words,  with  the 
direction  of  repression  and  the  content  of  the  uncon- 
scious; and  I  welcome  this  opportunity  to  attempt  to 
clarify  the  issue  (see  Levitsky,  1960). 

In  other  respects.  Dr.  Jourard's  formulation  is  certainly 
plausible.  Consciences  do  vary,  from  infancy  to  maturity, 
from  culture  to  culture,  and  from  individual  to  individual 
within  the  same  culture.  The  sociopath,  at  least  by 
definition  if  not  in  actual  fact,  is  a  person  with  an  under- 

*For  a  somewhat  similar  position,  see  Fenichel  (1954), 
Fromm  (1947)  and  Jung  (1938). 


28  The  Crisis  in  Psychiatry  and  Religion 

developed,  weak  conscience;  and  there  is  certainly  no  rea- 
son, a  priori,  why  in  other  individuals  conscience  might 
not  be  excessively  severe.  However,  it  is  not  my  wish  here 
to  debate  this  issue,  either  on  empirical  or  logical  grounds. 
Rather  do  I  wish  to  invite  attention  to  a  different  way  of 
conceptualizing  the  whole  matter  of  the  unconscious, 
conscience,  and  the  question  of  repression. 

THE   UNCONSCIOUS   RE-EXAMINED 

IN  A  RELIGIOUS   CONTEXT  I 

Psychologists,  despite  pretentions  of  open-mindedness 
and  scientific  objectivity,  have  in  certain  respects  been 
an  arrogant  and  bigoted  lot.  I  recall  hearing  a  colleague, 
in  the  mid-19  30s,  when  the  question  of  whether  we 
should  include  History  in  the  disciplines  represented  at 
the  Institute  of  Human  Relations  at  Yale,  say  that  we 
were  not  interested  in  History,  that  we  were  not  inter- 
ested even  in  the  History  of  Science,  that  we  were  in- 
terested only  in  making  Science.  And  certainly  there  has 
been  a  widespread  assumption  that  the  Future  was  ours 
alone.  Some  of  us  psychologists  are  now  old  enough  to 
feel  that  we  have  experienced  a  sizeable  piece  of  this 
Future,  and  we  are  by  no  means  sure  that  we  are  neces- 
sarily much  wiser  or  more  efficient  directors  of  destiny 
than  were  some  of  our  forebears.  Certainly  the  phe- 
nomena which  we  today  call  psychopathology  have  been 
known  to  mankind  for  a  very  long  time;  and  it  is  by  nc 
means  certain  that  our  progenitors  understood  or  man- 
aged them  less  well  than  do  we. 

Thus  chastened,  I,  as  a  psychologist,  have  found  mysell 
looking  with  renewed  interest  and  respect  at  some  of  the 
great  cultural  and  historical  documents  of  the  past;  anc. 
here  I  have  found  nothing  more  illuminating  than  thai 
remarkable  collection  of  writings  known  as  the  Ok 
Testament.  The  language  is  often  metaphorical  anc 
poetic;  but  the  basic  intent  and  content  of  these  writing: 
can  hardly  be  missed.  And  here  we  find,  unmistakably, 
psychiatry  which  is  at  one  with  religion. 

Old  Testament  writers  interpreted  their  own  and  thei: 
fellowmen's  emotional  anguish  as  a  manifestation  of  th« 
"wrath  of  Cod."  This  idea  is  found  in  Ecclesiastes  (5 
7),  Isaiah  (J 3,  9),  Psalms  (90),  and  elsewhere;  and  Jol 


Changing  Conceptions  of  the  Unconscious       29 

puts  it  succinctly  when  he  says,  ''Have  pity  upon  me, 
have  pity  upon  me,  O  my  friends;  for  the  hand  of  God 
hath  touched  me"  (19,  21).  But  the  theme  is  perhaps 
most  explicitly  and  fully  developed,  in  the  4th  Chapter  of 
Ist  Daniel,  in  the  account  of  the  madness  that  beset 
Nebuchadnezzar.  Being  afflicted  by  visions  and  dreams, 
the  King  called  Daniel  in  to  interpret  them  for  him.  After 
nuch  hesitation,  Daniel  told  the  King  that  he  had  be- 
:ome  vain  and  iniquitous,  and  that  he  was  going  to  have 
;o  suffer  grieviously  before  he  found  deliverance. 

And  at  the  end  of  the  days  [of  suffering  and  humiliation] 
I  Nebuchadnezzar  lifted  up  mine  eyes  unto  heaven,  and 
mine  understanding  returned  unto  me,  and  I  blessed  the 
most  High,  and  I  praised  and  honoured  him  that  liveth 
forever,  whose  dominion  is  an  everlasting  dominion,  and  his 
kingdom  is  from  generation  to  generation;  and  all  the  in- 
habitants of  the  earth  are  reputed  as  nothing:  and  he  doeth 
according  to  his  will  in  the  army  of  heaven,  and  among  the 
inhabitants  of  the  earth:  and  none  can  stay  his  hand,  or  say 
unto  him.  What  doest  thou? 

At  the  same  time  my  reason  returned  unto  me;  and  for 
the  glory  of  my  kingdom,  mine  honour  and  brightness  re- 
turned unto  me;  and  my  counsellors  and  my  lords  sought 
unto  me;  and  I  was  established  in  my  kingdom;  and  excellent 
majesty  was  added  unto  me. 

Here,  it  seems,  are  implications  of  a  most  profound 

md  far-reaching  kind.  Here,  if  I  understand  the  stories  of 

ob,  Nebuchadnezzar,  and  other  Old  Testament  charac- 

ers,  there  is  no  intimation  that  psychopathology  neces- 

arily  involves  repression;  surely  the  very  core  of  the  prob- 

em  is  that  God  has  spoken,  expressed  himself,  touched 

he  individual  in  question.  And  there  is  accordingly  no 

ntention  or  need  to  make  the  unconscious  conscious.* 

rhe  question  rather  is  why  God  and  conscience  have 

mitten  us  and  what  we  can  do  about  it. 

This  is  not  to  say,  of  course,  that  the  now  afflicted  in- 

ividual  may  not  have  previously  repressed  conscience 

nd  "denied  God."  The  wicked  are  often  referred  to  as 

hard  of  heart,"  calloused,  and  insensitive.  And  as  long 

*Cf.  Stekel's  remark,  "After  thirty  years'  experience  of 
Analysis,  I  no  longer  believe  in  the  overwhelming  significance 
If  the  unconscious  (in  the  Freudian  sense  of  that  term)" 
!l938,  p.  xx). 


30  The  Crisis  in  Psychiatry  and  Religion 

as  these  defenses  hold,  there  is  no  manifest  disturbance. 
Rather  the  "disease,"  if  we  may  now  use  that  term  in  a 
-Strictly  social  and  moral  sense,  is  to  this  point  a  purely 
latent  one;  and  when  conscience  finally  rebels  and  erupts, 
when,  in  Biblical  language  God's  patience  is  exhausted, 
the  individual  is  already  grappling  with  a  crisis  from  which 
he  may  emerge  a  chastened,  changed,  and  converted 
man  [see  also  Chapter  9]. 

Of  course,  in  a  certain  limited  sense  one  may  say  that 
religious  leaders  do  attempt  to  make  the  unconscious  con- 
scious, do  attempt  to  release  repressed,  imprisoned,  de- 
nied forces  of  personality.  To  the  hard  of  heart,  they  con- 
tinually put  forth  a  ''call  to  repentance,"  the  confession 
of  sin,  and  reaffirmation  of  obedience  to  the  good  and  to 
the  godly.  In  fact,  it  would  seem  that  this  is  one  of  the 
main  functions  of  regular  worship  on  the  part  of  the 
devout,  to  constantly  acknowledge  and  correct  their  way- 
wardness and  to  grow  in  the  "grace  and  admonition  of 
the  Lord." 

But  it  is  surely  equally,  or  even  more  importantly,  true 
that  remorse,  contrition,  and  dismay  often  break  out 
spontaneously  in  deviant  individuals  and  that  it  is  this 
state  of  manifest  disturbance  which  we  call  neurosis  or 
mental  illness  and  which  someone  is  supposed  to  "treat." 
Therefore,  it  would  seem  to  be  a  real  question  as  tO; 
whether  efforts  at  making  the  unconscious  conscious  arei 
relevant.  If,  by  the  unconscious,  we  now  mean  conscience! 
and  the  "Hand  of  God,"  the  task  would  seem  to  be 
quite  the  reverse,  namely  that  of  helping  the  individual 
find  what  he  can  do  that  will  please  God,  satisfy  con- 
science, and  thus  allow  him  once  more  to  "go  forth  in 
peace." 

Steeped  as  we  are,  in  this  generation,  in  a  particulai 
form  of  naturalism,  we  do  not  easily  assimilate  either  th( 
language  or  the  thought  forms  of  the  ancient  Hebrews 
but  if  the  interpretation  of  psychopathology  which  ha: 
just  been  suggested  be  correct,  its  naturalistic  basis  is  a- 
once  apparent.  To  me  it  has  been  helpful  to  recall  tha- 
a  child  can  operate  in  either  of  two  ways:  (a)  of  his  owi 
free  will  and  wish  or  (b)  under  parental  compulsion.  By 
acting  "like  a  big  boy  (or  girl),"  that  is  to  say,  maturely 
and  responsibly,  the  child  enjoys  many  privileges  and  feel 
and  indeed  is  "free."  But  if  the  child  "forgets"  or  ignore 


Changing  Conceptions  of  the  Unconscious        31 

ivhat  his  parents  have  tried  to  teach  him,  they  have  to 
reassert  their  authority,  with  an  ensuing  loss  of  freedom 
md  self-direction  on  the  part  of  the  child. 

In  like  manner,  may  we  not  assume  that  an  adult  is 
:ree,  i.e.,  self-determining  and  autonomous,  only  so  long 
is  he  is  good  and  that  when  he  sufficiently  violates  the 
^rust  of  conscience,  the  latter  ''takes  over,"  perhaps  far 
from  gently  and  almost  certainly  with  a  feeling  on  the 
jjart  of  the  individual  that  ''things  are  happening  to  me." 
Like  the  parents  of  an  earlier  day,  conscience  thus  de- 
prives the  individual  of  his  freedom  and  will  restore  it 
|)nly  when  he  has  shown  that  he  can  again  be  trusted, 
rhus,  the  objective  of  therapy  is  not  to  "make  the  un- 
;onscious  conscious."  If  the  view  just  indicated  is  valid, 
:he  very  root  of  the  difficulty  is  that  the  unconscious 
[now  understood  as  conscience)  is  all  too  much  in  evi- 
ience — and  the  objective  is  to  get  it  to  subside,  retreat, 
elax;  and  this  it  will  presumably  do  only  when  the  ego 
)r  autonomous  part  of  the  personality  has  redeemed 
tself. 

I  Religion,  in  its  most  vital  and  significant  form,  has 
ilways  been  intent  upon  saving  "lost  souls,"  i.e.,  in  help- 
ng  individuals  regain  their  sense  of  peace  and  freedom 
hrough  a  return  to  responsible  living,  integrity,  and 
:oncern  and  compassion  for  others.  This,  it  seems,  is 
'therapy"  of  the  most  profound  variety;  and  it  is  perhaps 
lur  great  misfortune  that  this  conception  is  today  ac- 
epted  and  practiced  with  so  little  confidence. 

IMPLICATIONS   FOR   PSYCHOTHERAPY,    COUNSELING, 
AND    "ego   psychology" 

I  If  space  permitted,  it  would  perhaps  be  profitable  to 
ry  to  relate  the  foregoing  discussion  to  that  somewhat 
haotic  but  vigorously  growing  system  of  thought  known 
Is  contemporary  learning  theory.  Starting  as  it  did  with 
list  the  two  concepts  of  objectively  observable  stimula- 
ion  and  response,  learning  theory  has  gradually  incorpo- 
ated  certain  subjective,  or  "intervening,"  variables,  no- 
ably  those  of  fear,  relief,  hope,  and  disappointment.  Karl 
/[uenzinger,  at  the  University  of  Colorado,  has  recently 
uggested  a  way  in  which  "courage"  can  be  operationally 
lefined  and  empirically  studied  in  rats  or  other  laboratory 


32  The  Crisis  in  Psychiatry  and  Religion 

animals;  and  I  think  it  entirely  probable  that  learning 
theory  will  soon  be  elaborated  to  the  point  that  it  can 
be  equally  precise  and  explicit  about  the  phenomenon  of 
guilt.  Already  some  progress  has  been  made  in  this  con- 
nection, but  it  would  carry  us  too  far  afield  to  discuss  this 
matter  further  [cf.  Mowrer,  1960b;  1961]. 

Recently  I  was  much  interested  and,  I  confess,  not  a 
little  surprised  to  hear  a  physiological  psychologist  state 
that  there  is  some  evidence  that  the  neurological  cor- 
relates of  the  unconscious  mind  have  now  been  at  least 
roughly  identified  and  that  there  is  apparently  here  a 
capacity  for  gross  emotional  conditioning  which  may  later 
affect  the  individual  in  ways  very  similar  to  those  already 
attributed  to  conscience  in  this  paper.  Here,  likewise,  we 
will  await  further  developments  eagerly,  with  the  pos- 
sibility in  mind  that  we  may,  at  long  last,  be  approach- 
ing a  way  of  thinking  about  psychopathology  which 
articulates  not  only  with  social  psychology  and  religion 
but  also  with  learning  theory  and  neurophysiology. 

But  there  is  a  more  immediate  consideration  before 
us.  A  few  months  ago  I  heard  a  theologian  say  that  al- 
though he  was  convinced  that  religion  is  relevant  to  the 
problem  of  mental  health,  he  did  not  regard  religion  asi 
sufficient  in  this  connection.  When  asked  to  elaborate,! 
the  theologian  said  that  he  meant,  quite  simply,  that  reli- 
gion can  deal  with  the  conscious  personality,  but  not 
with  unconscious  forces.  This  position  reflects,  of  course, 
one  way  in  which  the  church  has  tried  to  make  peace 
with  the  ^secular  healing  professions;  but  there  is  a  ques- 
tion as  to  whether  such  a  ''division  of  labor"  corresponds 
to  reality.  If  the  line  of  thought  we  have  pursued  in  this 
paper  is  even  remotely  valid,  religion,  at  its  best,  is  always 
concerned  with  the  unconscious,  conceived  as  conscience 
and  the  Voice  of  God.  The  God  of  Moses  was  known  as 
the  Invisible  God,  and  the  church,  quite  generally,  has 
been  concerned  with  helping  individuals  live  so  that  the} 
do  not  see  God  as  an  hallucination  or  hear  his  angr) 
voice.^ 

Now  if  our  general  point  of  view  here  is  tenable,  one 
would  have  to  entertain  the  same  misgivings  about  th( 

°  See  Boisen's  illuminating  discussion  (1952)  of  the  "ex 
ternalization  of  conscience";  also  Freud  on  the  ''delusion  o 
observation"  (1933,  p.  85). 


Changing  Conceptions  of  the  Unconscious       3B 

attempt  which  is  commonly  made  to  draw  a  Hne  between 
psychological  counseling  and  psychotherapy  on  the 
grounds  that  the  latter  deals  with  unconscious  material 
whereas  the  former  does  not  or  at  least  should  not.  In 
November,  1950,  the  University  of  Minnesota  was  host 
to  a  conference  on  ''Concepts  and  Programs  of  Counsel- 
ing"; and  at  that  time  I  gave  a  paper  entitled  "Anxiety 
Theory  as  a  Basis  for  Distinguishing  between  Counseling 
land  Psychotherapy."  Much  of  what  was  said  on  that  oc- 
jcasion  is  congruent  with  the  present  discussion.  Take  for 
;example  this  sentence:  "It  makes  an  enormous  difference 
(practically  whether  we,  as  therapists,  are  afraid  of  anxiety 
|in  our  patients  (or  in  ourselves)  [as  something  malignant 
and  destructive]  or  whether  we  see  it  as  essentially  a  con- 
structive ally  both  to  our  therapeutic  efforts  and  to  the 
best  trends  and  forces  within  the  patient"  (p.  26). 

But  I  also  took  the  position  that  we  should  clearly 
distinguish  between  two  forms  of  helping  activity — call 
them  what  you  will — the  one  of  which  involves  dealing 
with  essentially  normal  persons,  i.e.,  persons  whose  con- 
flicts and  difficulties  are  still  fully  conscious,  and  the  other 
involving  persons  in  whom  dissociation  and  repression 
have  already  occurred  and  where  there  is  therefore  an 
unconscious  to  deal  with.  While  such  a  distinction  may 
btill  have  a  limited  justification,  it  would  now  seem  that 
[the  psychological  counselor,  at  least  in  principle,  is  in 
piuch  the  same  position  as  the  religious  counselor.  If  our 
easoning  has  been  correct,  the  normal  individual  has 
ictually  a  "larger"  unconscious  than  does  a  disturbed  per- 
on;  and  support,  direct  admonition,  and  counsel  may 
)e  one  of  the  best  means,  in  the  latter  case,  to  get  con- 
icience  to  relax  and  again  become  "unconscious."  As  al- 
■eady  suggested,  the  best  way  for  a  child  to  get  his  parents 
'off  his  back,"  to  use  a  common  but  graphic  expression, 
s  for  him  to  redeem  himself  with  respect  to  past  mis- 
deeds and  to  regain  their  confidence  and  trust  for  the 
[uture.  Likewise,  surely,  the  best  hope  of  the  conscience- 
;tricken  adult  is  to  associate  himself  with  other  persons 
)r  ideas  which  can  encourage  and  guide  him  into  paths 
)f  conduct  that  will  lead  ultimately  to  the  approval  rather 
han  condemnation  of  conscience. 

Today  it  is  difficult  to  discern  clearly  what  is  happening 
n  the  field  of  psychoanalysis.  In  general,  it  is  in  a  state 


34  The  Crisis  in  Psychiatry  and  Religion 

of  crisis  and  uncertainty  [cf .  Chapter  1 3] .  But  one  trend 
stands  out  rather  unmistakably,  namely,  the  growing  em- 
phasis upon  *'ego  psychology."  I  cannot  claim  to  have 
been  a  close  student  of  this  trend,  but  even  from  afar 
one  sees  in  it  developments  which  are  complementary  to 
the  thinking  we  are  here  exploring.  Here,  instead  of  stress- 
ing superego  over-severity,  we  find  more  reference  to  the 
importance  of  ego  adequacy.  Here  it  is  not  nearly  so  much 
a  question,  as  it  was  formerly,  of  how  to  pare  down  or 
reform  the  conscience;  rather  the  question  is,  how  to  get 
the  conscious  self-system  or  ego  of  the  individual  to  grow 
and  mature,  so  that  it  is  more  responsible  and  more  com- 
petent to  deal  with  the  manifold  demands  that  impinge 
upon  it.  Here,  surely,  the  work  of  the  minister,  the  coun- 
selor, the  teacher,  and  the  parent  are  all  highly  pertinent; 
and  where  intensive,  specialized  psychotherapy  becomes 
necessary,  it  is  presumably  not  so  much  a  question  of 
reversing  or  undoing  the  work  of  others  but  instead  a 
matter  of  trying  to  carry  on  where  others  have  left  off  or 
have  failed. 

On  the  whole,  however,  one  has  the  impression  that 
the  development  of  ego  psychology  has  not  as  yet  pro- 
ceeded very  far  in  psychoanalytic  quarters.  Certainly 
Federn's  1952  (posthumous)  volume.  Ego  Psychology 
and  the  Psychoses,  cannot  be  said  to  have  shed  any  great 
new  light  upon  these  matters.  This  book  is  abstruse  and 
still  so  heavily  encumbered  with  classical  psychoanalytic 
jargon  that  whatever  innovations  it  contains  are  very  hard 
to  discover.  Far  more  illuminating  and,  it  would  seem, 
more  promising  is  the  approach  suggested  by  Shoben  in 
his  paper  entitled,  "Toward  a  Concept  of  the  Normal 
Personality"  (1957).  Although  he  does  not  use  the  term, 
Shoben  here  is  largely  concerned  with  ego  psychology.  He 
says,  unequivocally,  that  the  normal,  integrated,  mature 
individual  must  of  necessity  be  concerned  with  self-con- 
trol, honesty,  personal  responsibility,  and  compassion  and 
affection  for  others  and  that  how  one  conceptualizes  life 
and  interpersonal  relationships  is  of  the  essence.  "Ideolo- 
gies are  at  issue  here,"  he  frankly  says  and  argues  persua- 
sively for  the  importance  also  of  values  and  value  systems. 
Here,  surely,  is  an  ego  psychology — and  one  with  which 
the  social  scientist  as  well  as  the  theologian  can  very 
largely  agree  [see  also  Waelder,  I960]. 


Changing  Conceptions  of  the  Unconscious      -^ 

Writing  on  the  Oxford  Group  movement,  in  1950, 
Walter  H.  Clark  described  the  difference  between  the 
aims  of  psychoanalysis  and  religion  thus:  ''Both  the  psy- 
chiatrist and  the  Group  want  to  reduce  the  sense  of  guilt 
— the  former  by  reducing  the  aim,  the  latter  by  increas- 
ing the  accomplishment"  (p.  238).  While  there  is  no 
denying  that  we  sometimes  set  for  ourselves  and  for 
others  unrealistic  aims,  yet  it  now  appears  that  less  harm 
is  usually  done  on  this  score  than  when  an  attempt  is 
made  to  be  dehberately  less,  morally,  than  we  potentially 
are.  A  scholarly  friend  tells  me  that  our  our  word  an- 
thopoid  comes  from  a  Greek  word  meaning,  "with  the 
head  up."  And  we  are  apparently  in  the  process  of  dis- 
covering that  we  cannot  solve  our  problems  by  looking 
"down"  without  also  losing  perhaps  the  most  distinctive 
aspect  of  our  humanity. 

FURTHER   IMPLICATIONS 

AND   CONCLUDING   OBSERVATIONS 

From  the  foregoing  discussion  it  would  seem  that  psy- 
chology and  related  disciplines  are  undergoing  a  period  of 
painful  reappraisal;  and  our  vision  and  understanding 
are  still  far  from  perfect  with  respect  to  the  end  points  of 
this  movement  and  change.  But  perhaps  the  way  is  suffi- 
ciently illuminated  for  us  to  see  before  us  a  few  steps 
further. 

Jourard  says  that  in  assuming  that  repression  can  be 
directed  toward  either  id  or  superego,  an  impasse  has 
been  reached;  and  we  have  here  tried  to  cut  through  that 
impasse  by  exploring  the  proposition  that  in  psychopa- 
thology  the  trouble  arises,  not  from  what  is  being  re- 
pressed, but  rather  from  what,  in  the  form  of  a  wrathful 
conscience,  is  being  expressed.  Past  disregard,  denial,  or 
'repression"  of  conscience  may,  to  be  sure,  account  for 
the  present  outbreak  or  "attack";  but  the  very  presence  of 
disturbance  means  that  the  repression  has  broken  down. 
And  the  psychotherapeutic  task,  it  would  seem,  is  much 
less  that  of  releasing  the  repressed  than  of  helping  the 
individual  understand  what  is  happening  to  him  and 
how  he  can  help  make  the  final  outcome  constructive 
rather  than  destructive. 

However,  our  hypothesis  does  not  at  the  same  time  ex- 


^^  ^^     The  Crisis  in  Psychiatry  and  Religion 

elude  the  possibility  of  impulse  repression,  in  at  least  a 
limited  sense.  For  some  time  now  I  have  been  interested 
in  collecting  illustrations  of  seemingly  bona  fide  impulse 
repression  but  which  call  for  an  interpretation  rather  dif- 
ferent from  the  one  Freud  proposed.  From  several  pos- 
sible examples,  allow  me  to  select  and  present  the  fol- 
lowing one,  because  of  its  simplicity  and  brevity.  It  was 
reported  to  me  by  a  colleague.  He  said  (as  I  later  recon- 
structed an  informal  conversation) : 

A  week  or  so  ago  I  had  an  experience  which  I  think  will 
interest  you,  as  a  psychologist.  Some  two  months  ago  the 
chairman  of  the  program  committee  of  an  organization  to 
which  I  belong  called  and  asked  me  to  recommend  someone 
as  the  speaker  at  the  annual  meeting  of  the  organization. 
This  I  did,  and  I  was  pleased,  when  the  occasion  arrived, 
that  the  person  whom  I  had  suggested  gave  a  quite  excellent 
and  well-received  talk.  Afterward,  however,  when  my  wife 
and  I  went  home,  I  found  I  was  vaguely  dispirited;  and,  dur- 
ing the  period  of  meditation  which  I  practice  before  going  to 
bed  each  night,  I  had  a  very  peculiar  experience.  It  was 
almost  as  if  there  was  a  "live  coal"  in  a  part  of  my  mind,  a 
sort  of  localized  "anxiety"  I  suppose  you'd  call  it.  Then,  all 
of  a  sudden,  I  realized  that  I  had  been  jealous  of  the  speaker; 
and  immediately  the  "burning"  sensation  within  me  dissolved. 
I  guess  I  knew  I  was  now  in  a  situation  where  I  couldn't  and 
wouldn't  act  upon  my  jealousy  so  it  was  safe  for  me  to  have 
the  feeling.  Needless  to  say,  I  was  ashamed  of  myself  for 
having  had  such  a  feeling. 

Here,  apparently,  was  a  situation  where  conscience,  far 
from  being  repressed,  had  been  instead  the  repressor. 
Like  a  parent  who  does  not  entirely  "trust"  a  small  child 
in  some  crucial  social  situation,  conscience  had  held  my 
friend,  so  to  say,  tightly  *'in  rein"  and  had  released  him 
only  when  the  chance  for  misconduct  had  passed.  There 
was,  presumably,  some  history  of  past  ungraciousness  and 
envy  in  situations  such  as  the  one  described;  and  it  would 
only  be  with  improved  self-control  and  a  genuine  "change 
of  heart"  on  the  part  of  the  individual  in  question  that , 
his  conscience  could  "trust"  him  to  handle  such  a  situa- 
tion responsibly  and  well.  Here  the  goal  of  "therapy" 
would  not  be  to  release  the  repressed  impulse  but  rather 
to  help  the  individual  grow  in  responsibility  and  "ego 
strength." 

The  term,  ego  strength,  can  of  course  be  easily  misun- 


Changing  Conceptions  of  the  Unconscious       B7 

derstood.  It  can  be  taken  to  imply  independence,  self- 
sufEciency,  and  even  selfishness  and  defiance.  As  we  are 
presently  conceiving  of  it,  the  term  implies  instead 
obedience  and  dedication  to  broad  social  objectives  and 
values.  Here  the  "strong"  individual  is  not  an  individual 
who  selfishly  demands  or  refuses  but  one  who  instead 
serves  and  is  loyal  to  a  set  of  high  social  ideals  and  values. 
The  point  of  view  here  expressed  is,  of  course,  mani- 
festly similar  to  that  of  religion.  Our  generation  is  one 
which  has  been  said  to  have  lost  its  "faith  in  God."  Per- 
haps this  loss  of  faith  is  related  to  a  misconception  of 
God,  which  the  church  itself,  in  recent  centuries,  has 
inadvertently  fostered.  God,  we  have  been  told,  is  some- 
thing out  there:  and  we  have  forgotten  that  there  is  ex- 
cellent precedence  for  thinking  of  God  also  as  some- 
thing  in  here,  a  part  of  our  own  selves  and  innermost  ex- 
perience. For  example,  consider  this  passage  from  I 
Kings: 

And  behold  the  Lord  passed  by,  and  a  great  and  strong 
wind  rent  the  mountains,  and  broke  in  pieces  the  rocks  be- 
fore the  Lord,  but  the  Lord  was  not  in  the  wind;  and  after 
the  wind  an  earthquake,  but  the  Lord  was  not  in  the  earth- 
quake; and  after  the  earthquake  a  fire,  but  the  Lord  was  not 
in  the  fire;  and  after  the  fire — a  still  small  voice  {IS:  11-12). 

Can  it  be  that  we  have  lost  faith  in  God  because  we 
have  lost  faith  in  conscience?  Our  widespread  use  of  al- 
cohol and  other  so-called  "tranquilizers"  is  surely,  from 
one  point  of  view,  an  expression  of  distrust  of  conscience; 
and  in  classical  psychoanalysis,  with  its  premise  about  the 
over-severity  of  the  superego,  the  distrust  is  even  more  ex- 
plicit. There,  as  Boisen  observes,  the  therapeutic  aim  is 
likened  to  that  of  surgery,  with  the  superego  the  object  of 
interest.  We  are  now  beginning  to  suspect  that  where 
psychoanalysis  has  been  successful  in  its  avowed  aim,  the 
result  is  likely  to  be,  not  a  normal  human  being,  but  a 
person  with  manifest  tendencies  toward  psychopathy  and 
acting-out;  but  psychoanalysis  is  usually  not  so  effective 
[cf .  Chapter  1 3] .  One  of  the  cases  cited  by  Stekel  in  his 
chapter  on  "diseases  of  conscience"  has  to  do  with  a 
physician  from  India  who  had  come  to  Vienna  for  treat- 
ment— and,  also,  it  seems,  because  of  Vienna's  reputa- 
tion for  liberality  in  the  realm  of  sex. 


38  The  Crisis  in  Psychiatry  and  Religion 

The  patient  sprang  from  a  pious  family  [and]  I  pointed 
out  that  his  troubles  were  due  to  a  disease  of  conscience,  and 
told  him  that  the  sleeplessness  and  pruritus  would  cease  to 
trouble  him  if  he  refrained  from  the  libertinage  which  was 
contrary  to  the  principles  in  which  he  had  been  brought  up. 
Realizing  that  I  might  be  right,  he  broke  off  all  his  liaisons 
and  returned  to  a  fleshless  diet.  Thereupon  the  pruritus 
ceased,  and  he  slept  exceedingly  well.  .  .  . 

Psychologically  interesting  is  the  fact  that  [the  physician 
was,  however]  extremely  dissatisfied  with  the  results  of  the 
treatment.  He  had  expected  the  impossible.  I  ought  to  have 
freed  him  from  his  inward  inhibitions,  so  that  he  could  enjoy 
relations  with  as  many  women  as  he  pleased  (1938,  pp.  322- 
323). 

Conscience  would  thus  seem  not  readily  altered,  and 
perhaps  we  would  do  well  to  rethink  and  redirect  our 
would-be  therapeutic  strategies.  Certainly  it  is  not  easy 
to  be  a  man  as  well  as  an  animal,  to  be  dominated  by 
social  as  well  as  biological  considerations.  But  the  privilege 
of  declining  to  at  least  make  the  supreme  effort  is  ap- 
parently no  longer  ours.  Man  is  that  remarkable  and 
paradoxical  creature  who  has,  as  we  may  say,  domesti- 
cated, socialized,  and  civilized  himself,  historically  speak- 
ing; and  this  same  drama,  struggle,  and  high  calling  is  one 
which  is  repeated,  in  miniature,  in  each  of  us.  Therefore, 
the  issues  on  which  our  personal  success  or  failure,  our 
humanity  or  inhumanity,  our  sanity  or  insanity  hinges  are 
as  broad  as  the  total  human  enterprise;  and  the  preven- 
tion or  correction  of  our  human  shortcomings  can  hardly 
be  reduced  to  the  level  of  the  services  performed  by  an 
automobile  mechanic,  the  pharmacist  on  the  corner,  or 
even  the  surgeon — grateful  as  we  are  for  their  expert  and 
specialized  assistance  on  certain  occasions.  Surely  with 
the  slogan  of  the  National  Association  for  Mental  Health, 
we  can  agree:  "Mental  health  is  everybody's  business."" 
And  any  attempt,  on  the  part  of  any  professional  or  spe- 
cial-interest group  to  claim  omnipotence  and  ''full  re- 
sponsibility" in  this  field  is  as  presumptuous  as  it  is  illogi- 
cal. 

Is  a  society  "sick"  because  it  has  standards,  and  rules^ 
and  laws  and  punishes  offenders  thereof  by  fines,  im- 
prisonment, or  even  death?  Who  would  care  to  claim 
"full  responsibility"  in  this  area?  The  problem  is  neither 
larger  nor  smaller  than  our  struggle  to  be  fully  human. 


Changing  Conceptions  of  the  Unconscious        39 

And  is  an  individual  "sick"  because  he,  too,  has  standards 
and  punishes  himself,  sometimes  quite  severely,  for  devia- 
tion therefrom?  A  penitentiary  is  the  place  we  send  those 
whom  society  condemns;  and  a  mental  hospital  is  the 
abode  of  the  self-condemned — or,  as  Boisen  has  called  it, 
a  sort  of  this-worldly  purgatory,  from  which  a  person  may 
return,  to  a  more  abundant  life,  or  in  which  he  can  also 
sink  into  the  hell  of  a  living  death  [see  Chapter  3]. 

We  thought  it  a  great  gain  when,  a  century  or  so  ago, 
we  began  to  try  to  perceive  the  insane  as  sick  rather  than 
as  sinful.  But  we  are  now  wondering,  to  put  it  as  a  quip, 
if  sin  is  not  the  lesser  of  two  evils  [cf .  Chapter  4] .  Citing 
the  supporting  views  of  Marzolf  and  Riese,  Shoben  says : 

Recently,  there  has  been  a  considerable  dissatisfaction  with 
the  whole  notion  of  interpreting  psychological  states  in 
terms  of  disease  analogies.  Maladjustive  behavior  patterns,  the 
neuroses,  and — perhaps  to  a  lesser  extent —  the  psychoses 
may  possibly  be  better  understood  as  disordered,  ineffective, 
and  defensive  styles  of  life  than  as  forms  of  sickness  (1957, 
p.  184). 

One  of  the  features  of  the  Protestant  Reformation  that 
gave  it  such  dynamic  power  and  wide  appeal  was  the  doc- 
trine of  "the  priesthood  of  all  believers"  and  belief  in 
"the  sanctity  of  the  common  life."  Nothing,  it  would 
seem,  short  of  a  similarly  broad  and  universal  invitation 
and  challenge,  to  each  and  every  member  of  contem- 
porary society,  can  represent  a  fully  rational  and  poten- 
tially more  effective  attack  upon  contemporary  man's 
faltering  faith  and  tottering  reason. 


Some  Constructive  Features 
of  the  Concept  of  Sin* 

As  long  as  one  adheres  to  the  theory  that  psychoneuro-  j 
sis  implies  no  moral  responsibility y  no  error,  no  misdeed  j 
on  the  part  of  the  afflicted  person,  ones  vocabulary  can,  ■ 
of  course,  remain  beautifully  objective  and  '' scientific ^  \ 
But  as  soon  as  there  is  so  much  as  a  hint  of  personal  ac-  \ 
countability  in  the  situation,  such  language  is,  at  the  i 
very  least,  wide  of  the  mark  and,  conceivably,  quite  mis-  ] 
leading.  Therefore,  if  ''moral  judgment''  does  enter  the  \ 
picture,  one  might  as  well  beard  the  lion  and  use  the  \ 
strongest  term  of  all,  sin.  This  is  the  strategy  involved  in  • 
the  present  and  following  chapter.  1 

But  there  is  also  a  deeper  objective  here.  ''Sickness/*  as  \ 
we  shall  see  increasingly  in  later  chapters,  is  a  concept  ] 
which  generates  pervasive  pessimism  and  confusion  in 
the  domain  of  psychopathology;  whereas  sin,  for  all  its 
harshness,  carries  an  implication  of  promise  and  hope,  a 
vision  of  new  potentialities.  Just  so  long  as  we  deny  the 
reality  of  sin,  we  cut  ourselves  off,  it  seems,  from  the 
possibility  of  radical  redemption  {"recovery*'). 

In  some  ways  it  is  perhaps  not  surprising  that  we  are  ■ 
assembled  here  today  to  explore  the  question  of  whether  ^ 
real  guilt,  or  sin,  is  relevant  to  the  problem  of  psychopa- 
thology and  psychotherapy.  For  half  a  century  now  we  I 
psychologists,  as  a  profession,  have  very  largely  followed  ^ 
the  Freudian  doctrine  that  human  beings  become  emo-  J 
tionally  disturbed,  not  because  of  their  having  done  any- 1 

*  One  of  four  papers  comprising  a  symposium  on  "The  Role  | 
of  the  Concept  of  Sin  in  Psychotherapy"  held  at  the  1959  | 
meeting  of  the  American  Psychological  Association,  in  Cin-  i 
cinnati,  Ohio  {American  Psychologist,  1959,  14,  356)  and  later  | 
published  in  the  Journal  of  Counseling  Psychology,  1960,  7, 
185-1 8 8. This  paper  has  also  appeared,  without  authorization,  in 
Catholic  Mind,  1960,  S8,  151-155.) 

40 


Constructive  Features  of  Concept  of  Sin        41 

thing  palpably  wrong,  but  because  they  instead  lack  in- 
sight. Therefore,  as  would-be  therapists  we  have  set  out 
to  oppose  the  forces  of  repression  and  to  work  for  under- 
standing. And  what  is  this  understanding,  or  insight, 
which  we  so  highly  prize?  It  is  the  discovery  that  the 
patient  or  client  has  been,  in  effect,  too  good;  that  he 
has  within  him  impulses,  especially  those  of  lust  and 
hostility,  which  he  has  been  quite  unnecessarily  inhibit- 
ing. And  health,  we  tell  him,  lies  in  the  direction  of 
recognizing  and  expressing  these  impulses. 

But  there  are  now  widespread  and,  indeed,  ominous 
signs  that  this  logic  and  the  practical  strategies  it  seems 
to  demand  are  ill-founded.  The  situation  is,  in  fact,  so 
grave  that,  as  our  presence  here  today  suggests,  we  are 
even  willing  to  consider  the  possibility  that  misconduct 
may,  after  all,  have  something  to  do  with  the  matter  and 
that  the  doctrine  of  repression  and  insight  are  more  mis- 
leading than  helpful. 

However,  as  soon  as  we  psychologists  get  into  a  dis- 
cussion of  this  problem,  we  find  that  our  confusion  is 
even  more  fundamental  than  might  at  first  appear.  We 
find  that  not  only  have  we  disavowed  the  connection 
between  manifest  misconduct  and  psychopathology;  we 
have,  also,  very  largely  abandoned  belief  in  right  and 
wrong,  virtue  and  sin,  in  general. 

On  other  occasions  when  I  have  seen  this  issue  under 
debate  and  anyone  has  proposed  that  social  deviousness 
is  causal  in  psychopathology,  there  is  always  a  chorus  of 
voices  who  clamor  that  sin  cannot  be  defined,  that  it  is 
culturally  relative,  that  it  is  an  unscientific  concept,  that 
it  is  a  superstition — and  therefore  not  to  be  taken  se- 
riously, either  in  psychopathology  or  in  ordinary,  every- 
day experience.  And  whenever  an  attempt  is  made  to 
answer  these  objections,  there  are  always  further  objec- 
tions— often  in  the  form  of  reductions  to  absurdity — 
which  involve  naivity  or  sophistry  that  would  ill-become 
a  schoolboy.  Historically,  in  both  literate  and  non-literate 
societies,  human  beings  are  supposed  to  have  reached  the 
age  of  discretion  by  early  adolescence;  yet  here  we  have 
the  spectacle  of  grown  men  and  women  soberly  insisting 
that,  in  effect,  they  cannot  tell  right  from  wrong — and 
that  no  one  else  can. 

Now  I  realize  how  futile  it  is  to  try  to  deal  with  this 


42  The  Crisis  in  Psychiatry  and  Religion 

kind  of  attitude  in  a  purely  rational  or  logical  way.  The 
subversive  doctrine  that  we  can  have  the  benefits  of 
orderly  social  life  without  paying  for  it,  through  certain 
restraints  and  sacrifices,  is  too  alluring  to  be  counteracted 
by  mere  reason.  The  real  answer,  I  believe,  lies  along 
different  lines.  The  unassailable,  brute  fact  is  that  per- 
sonality disorder  is  the  most  pervasive  and  baffling  prob- 
lem of  our  time;  and  if  it  should  turn  out  that  persons 
so  afflicted  regularly  display  (or  rather  hide)  a  life  of 
too  little,  rather  than  too  much,  moral  restraint  and  self- 
discipline,  the  problem  would  take  on  an  empirical 
urgency  that  would  require  no  fine-spun  argument. 

Sin  used  to  be — and,  in  some  quarters,  still  is — defined 
as  whatever  one  does  that  puts  him  in  danger  of  going  to 
Hell.  Here  was  an  assumed  cause-and-effect  relationship 
that  was  completely  metaphysical  and  empirically  un- 
verifiable;  and  it  is  small  wonder  that  it  has  fallen  into 
disrepute  as  the  scientific  outlook  and  method  have 
steadily  gained  in  acceptance  and  manifest  power.  But 
there  is  a  very  tangible  and  very  present  Hell-on-this-earth 
which  science  has  not  yet  helped  us  understand  very 
well;  and  so  I  invite  your  attention  to  the  neglected  but 
very  real  possibility  that  it  is  this  Hell — the  Hell  of 
neurosis  and  psychosis — to  which  sin  and  unexpiated 
guilt  lead  us  and  that  it  is  this  Hell  that  gives  us  one  of 
the  most,  perhaps  the  most  realistic  and  basic  criteria  for 
defining  sin  and  guilt.  If  it  proves  empirically  true  that 
certain  forms  of  conduct  characteristically  lead  human 
beings  into  emotional  instability,  what  better  or  firmer 
basis  would  one  wish  for  labeling  such  conduct  as  destruc- 
tive, self-defeating,  evil,  sinful?  ^ 

If  the  Freudian  theory  of  personality  disorder  were 
valid,  one  would  expect  neurotic  and  psychotic  individuals 
to  have  lead  exemplary,  yea  saintly  lives — to  have  been 

^  There  is,  admittedly,  an  element  of  circularity  in  the  above 
argument.  If  it  is  maintained  that  mental  illness  is  caused  by 
unacknowledged  and  unexpiated  sin,  or  real  guilt,  then  it  adds 
nothing  to  our  knowledge  to  define  sin  as  that  which  causes 
mental  illness.  In  fact,  there  is  a  sense  in  which  such  a  defini- 
tion is  not  only  circular  but  misleading  (see  Chapter  13).  Ob- 
viously, what  is  needed  is  an  independent  criterion  for  identify- 
ing sin  or  guilt — cf.  Chapters  10-11  and  Mowrer,  1961. 


Constructive  Features  of  Concept  of  Sin        45 

just  too  good  for  this  world.  The  fact  is,  of  course,  that 
such  individuals  typically  exhibit  lives  that  have  been  dis- 
orderly and  dishonest  in  extreme  degree.  In  fact,  this  is 
so  regularly  the  case  [see  Chapters  8  and  13]  that  one 
cannot  but  wonder  how  so  contrary  a  doctrine  as  that  of 
Freud  ever  gained  credence.  Freud  spurned  The  Wish 
and  exalted  Reality.  What  he  regarded  as  Reality  may 
yet  prove  to  have  been  the  biggest  piece  of  wishfulness  of 
all. 

Or,  it  may  be  asked,  how  is  it  if  sin  and  psychic  suffer- 
ing are  correlated  that  not  all  who  sin  fall  into  neurosis 
or  psychosis?  Here  the  findings  of  the  Kinsey  studies  are 
likely  to  be  cited,  showing  that,  for  example,  many  per- 
sons have  a  history  of  sexual  perversity  who  are  later  quite 
normal.  In  other  words,  the  argument  is  that  since  sin 
and  persistent  suffering  do  not  always  go  hand-in-hand, 
there  is  perhaps  no  relationship  at  all.  The  answer  to 
this  question  is  surely  obvious.  Some  individuals,  alas^ 
simply  do  not  have  enough  character,  or  conscience,  to 
be  bothered  by  their  sins.  These  are,  of  course,  the 
world's  psychopaths.  Or  an  individual  may  have  been 
caught  in  his  sin  and  punished  for  it.  Or  it  may  have 
weighed  so  heavily  on  his  conscience  that  he  himself 
has  confessed  it  and  made  appropriate  expiation.  Or^ 
quite  conceivably,  in  some  instances  the  individual,  with- 
out either  detection  or  confession,  may  have  set  upon  a 
program  of  service  and  good  works  which  has  also  brought 
him  peace  and  redemption.  In  other  words,  there  is, 
surely,  no  disposition  on  the  part  of  anyone  to  hold  that 
sin,  as  such,  necessarily  dooms  a  person  to  interminable 
suffering  in  the  form  of  neurosis  or  psychosis.  The  pre- 
sumption is  rather  that  sin  has  this  effect  only  where  it 
is  acutely  felt  but  not  acknowledged  and  corrected. 

Also,  it  is  sometimes  contended  that  individuals  who 
eventually  come  to  the  attention  of  psychotherapists  have, 
to  be  sure,  been  guilty  of  major  errors  of  conduct;  but, 
it  is  held,  the  illness  was  present  first  and  the  misconduct 
|was  really  just  an  expression  or  symptom  thereof.  If  this 
were  true,  where  then  would  we  draw  the  line?  Is  there 
no  such  thing  as  moral  responsibility  and  social  ac- 
countability at  all?  Is  every  mean  or  vicious  thing  that 
you  or  I,  as  ordinary  individuals,  do  not  sin  but  rather  an 


44  The  Crisis  in  Psychiatry  and  Religion 

expression  of  "illness"?  Who  would  seriously  hold  that  a 
society  could  long  endure  which  consistently  subscribed 
to  this  flaccid  doctrine? 

Then  there  is,  of  course,  the  view  that,  in  the  final 
analysis,  all  psychopathology — or  at  least  its  profounder 
forms — have  a  constitutional  or  metabolic  basis.  One 
must,  I  believe,  remain  open-minded  with  respect  to  this 
possibility — indeed,  perhaps  even  somewhat  hopeful  with 
respect  to  it;  for  how  marvelous  it  would  be  if  all  the 
world's  madness,  stupidity,  and  meanness  could  be  elimi- 
nated through  biochemistry.  But  over  the  years  we  have 
seen  one  approach  after  another  of  this  kind  come  into 
prominence,  with  much  heralding  as  the  long-awaited 
break-through  on  the  problem  of  mental  disease,  only  to 
fade  out  as  manifestly  not  quite  the  panacea  we  had 
imagined  it  to  be.  Some  of  us  may,  at  this  point,  even 
suspect  that  today  the  main  incentive  for  keeping  the 
biochemical  hypothesis  alive  is  not  so  much  the  support- 
ing empirical  evidence,  which  is  meager  enough,  but  in- 
stead the  fact  that  it  at  least  obliquely  justifies  the 
premise  that  the  whole  field  of  mental  disorder  is  the 
proper  and  exclusive  domain  of  medicine.  Also,  and 
again  somewhat  obliquely,  it  excuses  the  clergy  from 
facing  squarely  the  responsibilities  that  would  devolve 
among  them  if  neurosis  and  psychosis  should  indeed 
turn  out  to  be  essentially  moral  disorders. 

The  conception  of  personality  disturbance  which  at- 
taches major  etiological  significance  to  moral  and  inter- 
personal considerations  thus  faces  formidable  resistance, 
from  many  sources;  but  programs  of  treatment  and  pre- 
vention which  have  been  predicated  on  these  other  views 
have  gotten  us  nowhere,  and  there  is  no  clear  reason  to 
think  they  ever  will.  Therefore,  in  light  of  the  total  situa- 
tion, I  see  no  alternative  but  to  turn  again  to  the  old, 
painful,  but  also  promising  possibility  that  man  is  pre- 
eminently a  social  creature  and  that  he  lives  or  dies, 
psychologically  and  personally,  as  a  function  of  the  open- 
ness, community,  relatedness,  and  integrity  which  by 
good  action  he  attains  and  by  evil  action  destroys. 

As  long  as  we  could  believe  that  the  psychoneurotic's 
basic  problem  was  not  evil  but  a  kind  of  ignorance,  it 
did  not  seem  too  formidable  a  task  to  give  him  the^ 
requisite  enlightenment  or  insight.  But  mental  hospital^ 


Constructive  Features  of  Concept  of  Sin        45 

are  now  full  of  people  who  have  had  this  kind  of  therapy, 
in  one  guise  or  another,  and  found  it  wanting;  and  if  we 
are  thus  forced  to  reconsider  the  other  alternative,  the 
therapeutic  or  redemptive  enterprise,  however  clear  it 
may  be  in  principle,  is  by  no  means  simple  in  practice.  If 
the  problem  is  genuinely  one  of  morality,  rather  than 
pseudo-morality,  most  of  us  in  the  secular  healing  profes- 
sions, of  psychology,  psychiatry,  or  social  work,  find  our- 
selves reduced  to  the  status  of  laymen,  with  no  special 
itraining  or  competence  for  dealing  with  or  even  approach- 
ing the  problem  in  these  terms.  We  know  something,  of 
course,  about  procedures  for  getting  disturbed  persons  to 
talk  about  themselves,  free-associate,  "confess";  but  the 
Iwhole  aim  of  this  strategy  has  been  insight,  not  redemp- 
tion and  personal  reformation.  And  clergymen  themselves 
Eave  so  often  been  told,  both  by  their  own  leaders  and 
y  members  of  the  secular  healing  professions,  that  they 
must  recognize  their  own  "limitations"  and  know  when 
to  "refer"  that  they,  too,  lack  the  necessary  confidence 
and  resources  for  dealing  with  these  problems  ade- 
quately [cf.  Chapters  11,  12]. 

Many  present-day  psychoanalysts  will  offer  no  serious 
objection  to  the  way  in  which  classical  Freudian  theory 
and  practice  have  been  evaluated  in  this  paper;  but  they 
will  insist  that  many  "advances"  have  been  made  since 
Freud's  time  and  that  these  put  the  whole  problem  in  a 
very  different  light.  If  we  ask,  "Precisely  what  are  these 
advances?"  we  are  told  that  they  have  to  do  with  the 
pew  emphasis  upon  "ego  psychology"  rather  than  upon 
I'the  unconscious."  But  what  did  Emalian  Gutheil 
(1958)  tell  us  at  our  convention  last  year  in  Washington 
ibout  ego  psychology?  He  said  that  although  analysts 
low  recognize  the  ego  as  much  more  important  than 
"ormerly,  they  know  next  to  nothing  about  the  conditions 
"or  modifying  or  strengthening  it;  and  the  same  position 
las  been  voiced  earlier  by  Lawrence  Kubie  (1956)  and 
in  one  of  his  very  last  papers  (1937)  even  by  Freud  him- 
jelf  [see  also  Chapter  13]. 

'  Therefore,  I  do  not  see  how  we  can  avoid  the  conclu- 
sion that  at  this  juncture  we  are  in  a  real  crisis  with 
respect  to  the  whole  psychotherapeutic  enterprise.  But  I 
do  not  think  we  are  going  to  remain  in  this  crisis,  con- 
"used  and  impotent,  indefinitely.  There  is,  I  believe,  grow- 


46  The  Crisis  in  Psychiatry  and  Religion 

ing  realism  with  regard  to  the  situation  on  the  part  of 
both  psychologists  and  psychiatrists,  on  the  one  hand, 
and  ministers,  rabbis,  and  priests,  on  the  other;  and  I  am 
hopeful  and  even  confident  that  new  and  better  ways  of 
dealing  with  the  situation  are  in  the  making. 

What,  precisely,  these  ways  will  be  I  do  not  know;  but : 
I  venture  the  impression  that  Alcoholics  Anonymous; 
provides  our  best  present  intimation  of  things  to  come: 
and  that  the  therapeutic  programs  of  the  future,  whethen 
under  religious  or  secular  auspices,  will,  like  AA,  take: 
guilt,  confession,  and  expiation  seriously  and  will  involve: 
programs  of  action  rather  than  mere  groping  for  "in- 
sight" [cf.  Chapters  8  and  12]. 


4 

*'Sin,"  the  Lesser  of  Two  Evils* 

When  the  paper  which  constitutes  the  preceding  chap- 
ter was  delivered  at  the  symposium  for  which  it  was  pre- 
pared, it  created  something  of  a  ''sensation^  There  was 
considerable  stir  over  it  at  the  convention  itself;  and 
stories  appeared  widely  in  newspapers  and  national  maga- 
zines, including  Time  [Sept.  14,  1959 — *'The  idea  of  sin, 
at  least  for  use  in  treating  the  sick  psyche,  is  making  a 
comeback/'  p.  69),  Newsweek  {Sept.  14,  1959,  p.  108), 
and  America  {Sept.  12,  1960,  pp.  686-687). 

Because  the  symposium  paper  was,  of  necessity,  brief 
and  left  many  facets  of  a  complex  problem  unexplored, 
it  seemed  desirable  to  write  a  supplementary  paper, 
which  is  reproduced  herewith.  In  it  a  number  of  con- 
siderations are  touched  upon  which  open  the  way  for 
more  systematic  discussion  in  subsequent  chapters. 

Following  the  presentation  of  a  paper  on  ''Construc- 
tive Aspects  of  the  Concept  of  Sin  in  Psychotherapy"  at 
the  1959  APA  convention  in  Cincinnati,  I  have  re- 
peatedly been  asked  by  psychologists  and  psychiatrists : 
"But  why  must  you  use  that  awful  word  'sin,'  instead  of 
some  more  neutral  term  such  as  'wrongdoing,'  'irre- 
sponsibility,' or  'immorality'?"  And  even  a  religious  lay- 
man has  reproached  me  on  the  grounds  that  "Sin  is  such 
a  strong  word."  Its  strength,  surely,  is  an  asset,  not  a 
Hability;  for  in  the  face  of  failure  which  has  resulted  from 
our  erstwhile  use  of  feebler  concepts,  we  have  very  heavy 
work  for  it  to  do.  Besides,  sin  (in  contrast  to  its  more 
neutral  equivalents)  is  such  a  handy  little  word  that  it 
would  be  a  pity  to  let  it  entirely  disappear  from  usage. 
With  Humpty-Dumpty,  we  ought  to  expect  words  to  be 
"well-behaved"  and  to  mean  what  we  want  them  to! 

*  Read  at  a  luncheon  meeting  of  The  University  Religious 
Council,  Ohio  State  University,  Columbus,  March  11,  1959, 
and  published  in  The  American  Psychologist,  1960,  15,  301- 
'304. 

i  47 


48  The  Crisis  in  Psychiatry  and  Religioi 

A  few  years  ago  I  was  invited  to  teach  in  the  summ( 
session  at  one  of  our  great  Pacific  Coast  universities;  anc 
toward  the  end  of  the  term,  a  student  in  my  class  on 
Personahty  Theory  said  to  me  one  day:  ''Did  you  know 
that  near  the  beginning  of  this  course  you  created  a  kind 
of  scandal  on  this  campus?"  Then  he  explained  that  I 
had  once  used  the  word  "sin"  without  saying  "so-called" 
or  making  a  joke  about  it.  This,  the  student  said,  was 
virtually  unheard-of  in  a  psychology  professor  and  had 
occasioned  considerable  dismay  and  perplexity.  I  did  not 
even  recall  the  incident;  but  the  more  I  have  thought 
about  the  reaction  it  produced,  the  more  frequently  I 
have  found  myself  using  the  term — with,  I  hope,  some- 
thing more  than  mere  perversity. 

Traditionally,  sin  has  been  thought  of  as  whatever 
causes  one  to  go  to  Hell;  and  since  Hell,  as  a  place  of 
otherworldly  retribution  and  torment,  has  conveniently 
dropped  out  of  most  religious  as  well  as  secular  thought, 
the  concept  of  sin  might  indeed  seem  antiquated  and 
absurd.  But,  as  I  observed  in  the  Cincinnati  paper.  Hell 
is  still  very  much  with  us  in  those  states  of  mind  and 
being  which  we  call  neurosis  and  psychosis;  and  I  have 
come  increasingly,  at  least  in  my  own  mind,  to  identify 
anything  that  carries  us  toward  these  forms  of  perdition 
as  sin.  Irresponsibility,  wrongdoing,  immorality,  sin:^ 
what  do  the  terms  matter  if  we  can  thus  understand 
more  accurately  the  nature  of  psychopathology  and  gain 
greater  practical  control  over  its  ramified  forms  and 
manifestations? 

But  now  the  fat  is  in  the  fire!  Have  we  not  been 
taught  on  high  authority  that  personality  disorder  is  not 
one's  own  "fault,"  that  the  neurotic  is  not  "responsible" 
for  his  suffering,  that  he  has  done  nothing  wrong,  com- 
mitted no  "sin"?  "Mental  illness,"  according  to  a  poster 
which  was  widely  circulated  a  few  years  ago,  "is  no  dis- 
grace. It  might  happen  to  anyone."  And  behind  all  this, 
of  course,  was  the  Freudian  hypothesis  that  neurosis  stems 
from  a  "too  severe  superego,"  which  is  the  product  of  a 
too  strenuous  socialization  of  the  individual  at  the  hands 
of  harsh,  unloving  parents  and  an  irrational  society.  The^ 
trouble  lay,  supposedly,  not  in  anything  wrong  or  "sinful" 
which  the  individual  has  himself  done,  but  in  things  he 
merely  wants  to  do  but  cannot,  because  of  repression. 


"Sin,"  the  Lesser  of  Two  Evils  49 

The  neurotic  was  thus  not  sinful  but  sick,  the  helpless, 
innocent  victim  of  "the  sins  of  the  fathers,"  and  could 
be  rescued  only  by  a  specialized,  esoteric  form  of  treat- 
ment. Anna  Russell  catches  the  spirit  of  this  doctrine  well 
when  she  sings,  in  'Tsychiatric  Folksong," 

At  three  I  had  a  feeling  of 

Ambivalence  toward  my  brothers, 
And  so  it  follows  naturally 

I  poisoned  all  my  lovers. 
But  now  I'm  happy;  I  have  learned 

The  lesson  this  has  taught; 
That  everything  I   do   that's  wrong 

Is  someone  else's  fault. 

Freud  saw  all  this  not  only  as  a  great  scientific  dis- 
covery but  also  as  a  strategic  gain  for  the  profession 
which  had  thus  far  treated  him  so  indifferently.  It  was 
one  may  conjecture,  a  sort  of  gift,  an  offering  or  service 
which  would  place  medicine  in^^ueh  debt  to  him  that 
it  could  no  longer  ignore  or  reject  him.  In  his  Auto- 
TwgraphyTimd  { 193 5 )  puts  it  thus: 

My  medical  conscience  felt  pleased  at  my  having  arrived 
at  this  conclusion  [that  neurosis  has  a  sexual  basis].  I  hoped 
that  I  had  filled  up  a  gap  in  medical  science,  which,  in  deal- 
ing with  a  function  of  such  great  biological  importance,  had 
failed  to  take  into  account  any  injuries  beyond  those  caused 
by  infection  or  by  gross  anatomical  lesions.  The  medical 
aspect  of  the  matter  was,  moreover,  supported  by  the  fact  that 
sexuality  was  not  something  purely  mental.  It  had  a  somatic 
side  as  well  .  .  .  (p.  45). 

In  his  book  on  The  Problem  of  Lay  Analysis^  Freud 
(1927)  later  took  a  somewhat  different  position  (see  also 
Chapter  9  of  the  third  volume  of  Jones'  biography  of 
Freud,  1957);  but  by  this  time  his  Big  Idea  had  been  let 
loose  in  the  world  and  was  no  longer  entirely  under  his 
control. 

Psychologists  were,  as  we  know,  among  the  first  of 
the  outlying  professional  groups  to  "take  up"  psycho- 
analysis. By  being  analyzed,  we  not  only  learned — in  an 
intimate,  personal  way — about  this  new  and  revolutionary 
science;  we  also  (or  so  we  imagined)  were  qualifying 
ourselves  for  the  practice  of  analysis  as  a  form  of  therapy. 


50  The  Crisis  in  Psychiatry  and  Religion 

Now  we  are  beginning  to  see  how  illusory  this  all  was. 
We  accepted  psychoanalytic  theory  long  before  it  had 
been  adequately  tested  and  thus  embraced  as  ''science" 
a  set  of  presuppositions  which  we  are  now  painfully  hav- 
ing to  repudiate.  But,  more  than  this,  in  accepting  the 
premise  that  the  neurotically  disturbed  person  is  basically 
sick,  we  surrendered  our  professional  independence  and 
authenticity.  Now,  to  the  extent  that  we  have  subscribed 
to  the  doctrine  of  mental  illness  (and  tried  to  take  part 
in  its  "treatment"),  we  have  laid  ourselves  open  to  some 
really  very  embarrassing  charges  from  our  friends  in  psy- 
chiatry. 

In  1954  the  American  Psychiatric  Association,  with 
the  approval  of  the  American  Medical  Association  and 
the  American  Psychoanalytic  Association,  published  a 
resolution  on  "relations  between  medicine  and  psy- 
chology," which  it  re-issued  (during  the  supposed  "mor- 
atorium") in  1957.  This  document  needs  no  exten- 
sive review  in  these  pages;  but  a  few  sentences  may  be 
quoted  to  indicate  what  a  powerful  fulcrum  the  sickness 
conception  of  neurosis  provides  for  the  aggrandizement 
of  medicine. 

For  centuries  the  Western  world  has  placed  on  the  medi- 
cal profession  responsibility  for  the  diagnosis  and  treatment 
of  illness.  Medical  practice  acts  have  been  designed  to  protect 
the  public  from  unqualified  practitioners  and  to  define  the 
special  responsibilities  assumed  by  those  who  practice  the 
healing  art.  .  .  .  Psychiatry  is  the  medical  speciality  con- 
cerned with  illness  that  has  chiefly  mental  symptoms.  .  .  . 
Psychotherapy  is  a  form  of  medical  treatment  and  does  not 
form  the  basis  for  a  separate  profession.  .  .  .  When  mem- 
bers of  these  [other]  professions  contribute  to  the  diagnosis 
and  treatment  of  illness,  their  professional  contributions  must 
be  coordinated  under  medical  responsibility  (pp.  1-2). 

So  long  as  we  subscribe  to  the  view  that  neurosis  is  a  i 
bona  fide  "illness,"  without  moral  implications  or  dimen- 
sions, our  position  will,  of  necessity,  continue  to  be  an 
awkward  one.  And  it  is  here  I  suggest  that,  as  between 
the  concept  of  sin  (however  unsatisfactory  it  may  in 
some  ways  be)  and  that  of  sickness,  sin  is  indeed  the 
lesser  of  two  evils.  We  have  tried  the  sickness  horn  of 
this  dilemma  and  impaled  ourselves  upon  it.  Perhaps, 


"Sin,"  the  Lesser  of  Two  Evils  51 

despite  our  erstwhile  protestations,  we  shall  yet  find  sin 
more  congenial. 

We  psychologists  do  not,  I  believe,  object  in  principle 
to  the  type  of  authority  which  psychiatrists  wish  to  exer- 
cise, or  to  our  being  subject  to  other  medical  controls, 
if  they  were  truly  functional.  But  authority  and  power 
ought  to  go  with  demonstrated  competence,  which  medi- 
cine clearly  has  in  the  physical  realm  but,  equally  clearly, 
jdoes  not  have  in  "'psychiatry."  Despite  some  pretentious 
affirmations  to  the  contrary,  the  fact  is  that  psycho- 
;analysis,  on  which  modern  "dynamic"  psychiatry  is  largely 
ibased,  is  in  a  state  of  virtual  collapse  and  imminent 
idemise.  And  the  tranquilizers  and  other  forms  of  so- 
called  chemotherapy  are  admittedly  only  ameliorative, 
not  basically  curative.  So  now,  to  the  extent  that  we 
have  accepted  the  "illness"  postulate  and  thus  been 
lured  under  the  penumbra  of  medicine,  we  are  in  the 
ungraceful  maneuver  of  "getting  out."  ^ 

But  the  question  remains:  Where  do  we  go,  what  do 
we  do,  now?  Some  believe  that  our  best  policy  is  to 
become  frankly  agnostic  for  the  time  being,  to  admit 
that  we  know  next  to  nothing  about  either  the  cause  or 
correction  of  psychopathology  and  therefore  ought  to 
concentrate  on  research.  This  is  certainly  a  safe  policy, 
and  it  may  also  be  the  wisest  one.  But  since  this  matter 
of  man's  total  adjustment  and  psychosocial  survival  does 
not  quickly  yield  up  its  innermost  secrets  to  conventional 
types  of  scientific  inquiry,  I  believe  it  will  do  no  harm 
for  us  at  the  same  time  to  be  thinking  about  some 
frankly  ideological  matters. 

^Thoughtful  psychiatrists  are  also  beginning  to  question  the 
legitimacy  of  the  disease  concept  in  this  area.  In  an  article  en- 
titled 'The  Myth  of  Mental  Illness"  which  appeared  after  this 
paper  went  to  press,  Thomas  S.  Szasz  (1960)  is  particularly 
outspoken  on  this  score.  He  says:  ".  .  .  the  notion  of  mental 
illness  has  outlived  whatever  usefulness  it  might  have  had  and 
.  .  .  now  functions  merely  as  a  convenient  myth.  .  .  .  mental 
illness  is  a  myth,  whose  function  it  is  to  disguise  and  thus 
render  more  palatable  the  bitter  pill  of  moral  conflicts  in  hu- 
man relations"  (p.  118).  Szasz  entire  article  deserves  careful 
attention. 


52  The  Crisis  in  Psychiatry  and  Religion 

For  several  decades  we  psychologists  looked  upon  the 
whole  matter  of  sin  and  moral  accountability  as  a  great 
incubus  and  acclaimed  our  liberation  from  it  as  epoch- 
making.  But  at  length  we  have  discovered  that  to  be 
"free"  in  this  sense,  i.e.,  to  have  the  excuse  of  being 
"sick"  rather  than  sinful,  is  to  court  the  danger  of  also 
becoming  lost.  This  danger  is,  I  believe,  betokened  by 
the  widespread  interest  in  Existentialism  which  we  are 
presently  witnessing.  In  becoming  amoral,  ethically  neu- 
tral, and  "free,"  we  have  cut  the  very  roots  of  our  being; 
lost  our  deepest  sense  of  self-hood  and  identity;  and, 
with  neurotics  themselves,  find  ourselves  asking:  Who 
am  I?  What  is  my  destiny?  What  does  living  (existence) 
mean? 

In  reaction  to  the  state  of  near-limbo  into  which  we 
have  drifted,  we  have  become  suddenly  aware,  once 
again,  of  the  problem  of  values  and  of  their  centrality 
in  the  human  enterprise.  This  trend  is  clearly  apparent 
in  the  programs  at  our  recent  professional  meetings,  in 
journal  articles,  and,  to  some  extent  already,  in  our 
elementary  textbooks.  Something  very  basic  is  obviously 
happening  to  psychologists  and  their  "self-image." 

In  this  process  of  moving  away  from  our  erstwhile 
medical  "entanglements,"  it  would  be  a  very  natural 
thing  for  us  to  form  a  closer  and  friendlier  relationship 
than  we  have  previously  had  with  religion  and  theology. 
And  something  of  this  sort  is  unquestionably  occurring. 
At  the  APA  Annual  Convention  in  1956  there  was,  for 
the  first  time  in  our  history  I  believe,  a  symposium  on 
religion  and  mental  health;  and  each  ensuing  year  has; 
seen  other  clear  indications  of  a  developing  rapproche-; 
ment.  | 

However,  here  too  there  is  a  difficulty — of  a  most 
surprising  kind.  At  the  very  time  that  psychologists  are 
becoming  distrustful  of  the  sickness  approach  to  person- 
ality disturbance  and  are  beginning  to  look  with  more 
benign  interest  and  respect  toward  certain  moral  and 
religious  precepts,  religionists  themselves  are  being  caught 
up  in  and  bedazzled  by  the  same  preposterous  system  of 
thought  as  that  from  which  we  psychologists  are  just 
recovering.  It  would  be  possible  to  document  this  develop- 
ment at  length;  but  reference  to  such  recent  "theological" 
works  as  Richard  V.  McCann's  Delinquency — Sicknesi 


'Sin,"  the  Lesser  of  Two  Evils  53 

or  Sin?  (1957)  and  Carl  Michalson's  Faith  for  Personal 
Crises  (1959,  see  especially  Chapter  3)  will  suffice. 

We  have  alluded  to  Anna  Russell's  ''Psychiatric  Folk- 
song" and,  in  addition,  should  call  attention  to  Katie 
Lee's  12-inch  LP  recording  "Songs  of  Couch  and  Con- 
sultation." That  entertainment  and  literary  people  are 
broadly  rejecting  psychoanalytic  froth  for  the  more  solid 
substance  of  moral  accountability  is  indicated  by  many 
current  novels  and  plays.  It  is  not  without  significance 
that  Arthur  Miller's  Death  of  a  Salesman,  written  in  the 
philosophical  vein  of  Hawthorne's  great  novel  The 
pcarlet  Letter,  has,  for  example,  been  received  so  well. 

How  very  strange  and  inverted  our  present  situation 
therefore  is!  Traditionally  clergymen  have  worried  about 
the  world's  entertainments  and  entertainers  and,  for  a 
time  at  least,  about  psychology  and  psychologists.  Now, 
ironically,  the  entertainers  and  psychologists  are  worrying 
about  the  clergymen.  Eventually,  of  course,  clergymen 
will  return  to  a  sounder,  less  fantastic  position;  but  in 
the  nieantime,  we  psychologists  can  perhaps  play  a  socially 
useful  and,  also,  scientifically  productive  role  if  we  pursue, 
ivith  all  seriousness  and  candor,  our  discovery  of  the 
essentially  moral  nature  of  human  existence  and  of  that 
'living  death"  which  we  call  psychopathology.  This,  of 
course,  is  not  the  place  to  go  deeply  into  the  substantive 
aspects  of  the  problem;  but  one  illustration  of  the  fruit- 
ulness  of  such  exploration  may  be  cited. 

In  reconsidering  the  possibility  that  sin  must,  after 
ill,  be  taken  seriously,  many  psychologists  seem  per- 
plexed as  to  what  attitude  one  should  take  toward  the 
nnner.  "Nonjudgmental,"  "nonpunitive,"  "nondirective," 
warm,"  "accepting,"  "ethically  neutral":  these  words 
liave  been  so  very  generally  used  to  form  the  supposedly 
Droper  therapeutic  imago  that  reintroduction  of  the 
oncept  of  sin  throws  us  badly  off  balance.  Our  attitudes, 
is  would-be  therapists  or  helping  persons,  toward  the 
aeurotic  (sinner)  are  apparently  less  important  than  his 
ittitude  toward  himself;  and,  as  we  know,  it  is  usually — 
in  the  most  general  sense — a  rejecting  one.  Therefore, 
we  have  reasoned,  the  way  to  get  the  neurotic  to  accept 
md  love  himself  is  for  us  to  love  and  accept  him,  an 
nference  which  flows  equally  from  the  Freudian  assump- 


54  The  Crisis  in  Psychiatry  and  Religion 

tion  that  the  patient  is  not  really  guilty  or  sinful  but 
only  fancies  himself  so  and  from  the  view  of  Rogers 
that  we  are  all  inherently  good  and  are  corrupted  by  our 
experiences  with  the  external,  everyday  world. 

But  what  is  here  generally  overlooked,  it  seems,  is 
that  recovery  (constructive  change,  redemption)  is  most 
assuredly  attained,  not  by  helping  a  person  reject  and 
rise  above  his  sins,  but  by  helping  him  accept  them. 
This  is  the  paradox  which  we  have  not  at  all  understood 
and  which  is  the  very  crux  of  the  problem.  Just  so  long 
as  a  person  lives  under  the  shadow  of  real,  unacknowl- 
edged, and  unexpiated  guilt,  he  cannot  (if  he  has  any 
character  at  all)  ''accept  himself";  and  all  our  efforts  to 
reassure  and  accept  him  will  avail  nothing.  He  willi 
continue  to  hate  himself  and  to  suffer  the  inevitable 
consequences  of  self-hatred.  But  the  moment  he  (with 
or  without  "assistance")  begins  to  accept  his  guilt  and! 
his  sinfulness,  the  possibility  of  radical  reformation  opens 
up;  and  with  this,  the  individual  may  legitimately,  though 
not  without  pain  and  effort,  pass  from  deep,  pervasive 
self-rejection  and  self-torture  to  a  new  freedom,  of  self- 
respect  and  peace. 

Thus  we  arrive,  not  only  at  a  new  (really  very  old)  | 
conception  of  the  nature  of  ''neurosis"  which  may  change  j 
our   entire   approach   to   this   problem,  but  also   at  an 
understanding  of  one  of  the  most  fundamental  fallacies 
of  Freudian  psychoanalysis  and  many  kindred  efforts  at. 
psychotherapy.  Freud  observed,  quite  accurately,  that  the 
neurotic  tortures  himself;  and  he  conjectured  that  this 
type  of  suffering  arose  from  the  irrationality  and  over- 
severity  of  the  superego.  But  at  once  there  was  an  em- 
pirical as  well  as  logical  difficulty  which  Freud  (unlike 
some  of  his  followers)   faithfully  acknowledged.  In  the 
New  Introductory  Lectures  on  Psychoanalysis   (1933), 
he  said: 

The  supergo  [paradoxically]  seems  to  have  made  a  one- 
sided selection  [as  between  the  loving  and  the  punitive  atti- 
tudes of  the  parents],  and  to  have  chosen  only  the  harshness, 
and  severity  of  the  parents,  their  preventive  and  punitive 
functions,  while  their  loving  care  is  not  taken  up  and  con- 
tinued by  it.  If  the  parents  have  really  ruled  with  a  rod  of 
iron,  we  easily  understand  the  child  developing  a  severe  su- 
perego, but,  contrary  to  our  expectations,  experience  shows 


Sin,"  the  Lesser  of  Two  Evils  55 

that  the  supergo  may  reflect  the  same  relentless  harshness 
even  when  the  up-bringing  has  been  gentle  and  kind  (p.  90). 

And  then  Freud  adds,  candidly:  *'We  ourselves  do  not 

feel  that  we  have  fully  understood  it."  In  this  we  can 

illy  agree.  For  the  only  way  to  resolve  the  paradox  of 

If-hatred  and  self-punishment  is  to  assume,  not  that 

represents  merely  an  "introjection"  of  the  attitudes  of 

thers,  but  that  the  self-hatred  is  realistically  justified  and 

ill  persist  until  the  individual,  by  radically  altered  atti- 

de  and  action^  honestly  and  realistically  comes  to  feel 

at  he  now  deserves  something  better.  As  long  as  one 

mains,  in  old-fashioned  religious  phraseology,  hard-of- 

eart  and  unrepentant,  just  so  long  will  one's  conscience 

old  him  in  the  vise-like  grip  of  "neurotic"  rigidity  and 

offering.  But  if,  at  length,  an  individual  confesses  his 

ast  stupidities  and  errors  and  makes  what  poor  attempts 

le  can  at  restitution,  then  the  superego  (like  the  parents 

an  earlier  day — and  society  in  general)  forgives  and 
laxes  its  stern  hold;  and  the  individual  once  again  is 
ee,  "well"  [cf.  Chapter  2]. 

But  here  we  too,  like  Freud,  encounter  a  difficulty, 
here  is  some  evidence  that  human  beings  do  not  change 
idically  unless  they  first  acknowledge  their  sins;  but  we 
so  know  how  hard  it  is  for  one  to  make  such  an 
knowledgment  unless  he  has  already  changed.  In  other 
ords,  the  full  realization  of  deep  worthlessness  is  a 
vere  ego  "insult";  and  one  must  have  some  new  source 

strength,  it  seems,  to  endure  it.  This  is  a  mystery  (or 

it  only  a  mistaken  observation?)  which  traditional 
leology  has  tried  to  resolve  in  various  ways — v/ithout 
)mplete  success.  Can  we  psychologists  do  better? 


\ 


Judgment  and  Suflfering: 
Contrasting  Views* 

It  has  been  argued  that  if  real  rather  than  false  (Freud- 
ian) guilt  is  at  the  root  of  neurosis  and  functional 
psychosis,  then  therapy  should,  logically,  take  the  form 
of  ''punishment''  rather  than  ''treatment^  Yet  the  elim- 
ination of  punishment  ["mistreatment'')  of  the  insane 
has  been  regarded  as  a  great  cultural  and  humane  achieve- 
ment of  the  last  century  or  two.  Here,  obviously,  is  c 
complicated  issue,  which  has  already  been  alluded  to  neat 
the  end  of  the  preceding  chapter.  While  it  is  not  certair, 
j  that  punishment  from  without  {e.g.,  the  use  of  electro- 
j  convulsive  shock)  has  no  legitimate  place  in  a  restorative 
\  program,  the  fact  is  that  the  distinguishing  feature  O] 
most  forms  of  psychopathology  is  that  the  individua 
is  punishing  himself — or  at  least  trying  to.  The  questior 
is.  How  should  we  interpret  this  tendency,  as  "crazy'] 
or  potentially  curative?  Other  aspects  of  this  intricaU 
but  important  problem  will  be  considered,  from  timi 
to  time,  in  later  chapters. 

In  May,  1959,  it  was  my  good  fortune  to  participate 
in  a  week-long  institute  held  at  the  University  of  Sas 
katchewan  under  the  auspices  of  the  Provincial  Govern 
ment,  primarily  for  psychologists;  but  there  were  alsc 
three  psychiatrists  and  a  clergyman  in  the  group,  so  tha 
our  discussions  had  a  distinctly  interdisciplinary  flavor 
And  from  these  discussions  emerged  what  was  for  me  5 
new  insight  concerning  contemporary  attitudes  towarc 
suffering  which  I  believe  deserves  wider  consideration 

During  the  course  of  the  lectures  which  it  was  m; 
privilege  to  give,  I  reiterated  a  point  of  view  concerninj 
the  origin  and  meaning  of  psychopathology  which  ha 
been  taking  shape  in  my  mind  over  the  course  of  th< 
past  12  or  15  years.  Guilt,  I  argued,  is  the  central  prob 
lem — not   just   guilt   feelings,   as   Freud   so  beguilingl; 

*  Initially  published  in  Faculty  Forum,  October,  1959,  pp 
1-2. 

56 


JDGMENT  AND   SUFFERING  57 

iggested,  but  real,  palpable,  indisputable  guilt;  and 
ere  I  was  at  pains  to  review  clinical  evidence  that  dis- 
irbed  persons  are  not  ^'disturbed"  for  nothing.  Where 
eurosis  or  psychosis  is  purely  functional  (as  it  usually 
) ,  the  individual,  I  believe,  always  has  a  hidden  history 
E  serious  misconduct  which  has  not  been  adequately 
Dmpensated  and  ''redeemed."  And  if  this  be  so,  then 
Dnfession,  expiation,  and  ''a  new  life  in  Christ"  (or 
)me  equivalent  type  of  conversion)  have  a  practical 
ertinence  which  far  exceeds  the  boundaries  behind 
hich  some  theologians  have  attempted  to  hold  them. 
There  was,  I  may  say,  an  immediately  positive  response 
)  this  point  of  view  on  the  part  of  many  members  of 
le  group,  including  one  of  the  psychiatrists  and  several 
f  the  psychologists.  But  there  was  also  manifest  reserva- 
on  and  resistance  on  the  part  of  others;  so  we  took 
)me  time  to  hear  these  persons  out  and  try  to  under- 
:and  their  misgivings. 

;  Presently  it  emerged  that  several  of  the  members  of 

[ir  group  felt  that  this  point  of  view  was  ''punitive" 

jid  "rejecting"  and  "countertherapeutic";  for  how  could 

ae  accept  it,  they  asked,  without  blaming  the  patient 

id  being  disposed  to  punish  him?  These  avowals  brought 

;veral  important  issues  out  into  the  open.  First  of  all, 

ley  permitted  other  members  of  the  group  to  point  out 

lat  no  one  else  needs  to  blame  or  punish  the  mental 

ifferer:  he  is  blaming  and  punishing  himself  (or  at  least 

ying  to) — this  is  the  very  essence  of  his  condition. 

herefore,  we  can  and  should  show  him  all  the  love  and 

larity  within  our  souls,  and  do  not  need  in  the  least  to 

ay  a  punitive  role.  But  this  is  very  different  from  saying 

lat  we  should  dispute  or  brush  aside  his  assertions  of 

lilt  or  minimize  the  reality  of  his  need  for  deliverance. 

veral  members  of  the  group  expressed  the  conviction 

at  much  of  our  present  would-be  therapeutic  effort 

useless  and  even  harmful  because  we  so  actively  oppose 

e  patient's  own  most  substantial  psychological  realities 

d  his  brightest  prospects  for  change  and  recovery,  i.e., 

5  conviction  of  guilt  and  sense  of  sin.  Perhaps  the 

tient  is  not  so  wrong,  not  so  "crazy"  as  some  of  our 

m  theories  have  been! 

Then  our  discussion  took  a  historical  turn,  and  we 
:gan  to  see  how  widespread  and  pervasive  has  been,  in 


58  The  Crisis  in  Psychiatry  and  Religio 

recent  times,  the  belief  that  suffering  is  never  "de- 
served/' never  creative  and  reconstructive.  It  can  hardl) 
be  doubted  that  in  many  primitive  societies  the  notion 
of  accountabihty  is  overworked;  and  one  can  point  tc 
clear  examples  of  the  same  sort  of  thing  in  the  history 
of  Western  civilization.  For  example,  not  so  long  ago  we 
held  that  physical  illness  and  accidents  were  **God's 
judgment"  rather  than  the  wholly  impersonal  conse- 
quences of  germs  or  other  circumstances  beyond  the 
individual's  control;  and  we  also  were  inclined,  until 
fairly  recently,  to  suppose  that  all  poverty  must  reflect 
sloth  or  other  sins,  rather  than  recognize  social  injustice 
and  economic  exploitation. 

But  now,  in  our  reaction  against  this  patent  overexten- 
sion of  ''moral"  principle,  have  we  not  gone  too  far  iii 
the  other  direction?  There  is,  as  we  know,  a  widespreac 
tendency — sometimes  called  "scientism" — to  assume  thai 
human  beings  cannot  be  ''responsible"  for  anything,  thai 
we  are  all  just  cogs  in  a  vast  cause-and-effect  comple? 
and  are  in  no  way  accountable  for  anything  we  do  oi 
anything  that  happens  to  us.  Such  a  doctrine,  aside  fron 
its  lack  of  genuine  scientific  justification,  is  devastating 
no  society  could  long  endure  which  thoroughly  acceptec 
it — and  neither  can  an  individual  human  being  [cf 
Mowrer,  1961]. 

As  we  look  around  us,  at  mid-twentieth  century,  tw( 
of  the  most  distressing  "symptoms"  of  our  times  are  (a) 
confusion  and  apathy  in  the  matter  of  moral  value 
(witness  the  "beatnik"  movement)  and  (b)  an  apparen 
paralysis  with  respect  to  the  spectre  of  mental  illness 
Can  it  be  that  the  two  conditions  are  related  and  tha 
they  exist  in  such  acute  form  precisely  because  we  havt 
insisted  upon  separating  them?  Perhaps  mental  dis-easi 
has  a  meaning  and  a  potential  which  we  fail  to  recognize 

The  whole  thrust  of  medicine  is,  of  course,  in  th( 
direction  of  the  "alleviation  of  suffering";  and  we  an 
deeply  grateful  for  most  medical  efforts  and  accomplish 
ments.  But  when  medicine  extends  this  principle  ove 
into  the  moral  realm,  as  it  ostensibly  does  in  its  attemp 
to  treat  personality  disorders,  the  results  are  far  fron 
reassuring.  Psychoanalysis  promised  to  deliver  us  frori 
neurotic  suffering  by  the  bold  expedient  of  reducing  th 
"severity"  of  our  consciences.  Unable  to  make  good  thi 


UDGMENT  AND   SUFFERING  59 

iromise,  analysis  is  on  the  wane;  and  psychiatry  is  now 

aptivated  by  the  chemical  "tranquilizers."  Pick  up  an 

5sue  of  the  American  Journal  of  Psychiatry  (as  I  recently 

lid)   and  what  do  you  find?  Nine  of  the  ten  full-page 

T  two-page  advertisements  in  the  front  of  the  journal 

sading   as   follows:    "control   of   emotional   turbulence 

-luminal/'   "peace   of   mind — atarax,"    "calmness,   co- 

perativeness — serpasil,"  "relief  of  anxiety — compazine," 

valuable  in  all  degrees  of  psychic  disorder — trilafon," 

intravenous  anesthetic — pentothal,"  "relieves  tension — 

quanil,"  "normalizes  thinking — pacatal,"  "produces  re- 

ixation — sandril."  The  other  ad  was  for  a  portable  tape 

ecorder!  Combine  with  this  the  fact  that  such  a  large 

ercentage  of  other  forms  of  advertising  are  for  those 

e-old   "tranquilizers,"   alcohol  and   tobacco,   and   one 

es  that  the  diagnosis  of  our  time  as  the  "Aspirin  Age" 

a  magnificent  understatement.  What  would  happen 

modern  man  were  forced  to  confront  his  guilt  and 

security  for  just  one  week  without  these  masks  and 

dutches?  Would  it  destroy  us  completely  or  perhaps 

pint  the  way  to  a  saner  and  better  life? 

Historically,   the  church  has  been  dedicated  not  to 

mfort  but  to  change,  redemption,  rebirth.  Ultimately 

s  objective,  no  less  than  that  of  medicine,  was  to  relieve 

ffering — ^yea,  more,  to  bring  salvation  and  joy.  But  it 

d  not  flinch  from  holding  that  sometimes  suffering  is 

e  absolute  and  inescapable  precondition  for  our  trans- 

)rmation  and  redemption.  What  of  the  modern  church? 

s  child-rearing  became  permissive,  religion  also  became 

ion  judgmental"  and  obligingly  eliminated  Hell.  God 

now  love  and  love  alone,  and  judgment  is  old-fash- 

med.  This  past  week  a  student  put  into  my  hands  a 

eekly  bulletin  from  one  of  our  local  Protestant  churches 

hich  proclaims  that  God  is  "a  generous,  loving  Father" 

pose  "favor  toward  man  is  freely  given"  and  takes  the 

Oman  Catholics  to  task  for  "emphasizing  that  God  is 

pod  of  justice"! 

Old  Testament  writers  knew  that  God  and  parents 
id  conscience  can  be  justifiably  angry  and  that  we 
nore  them  at  our  peril.  In  denying  the  moral  implica- 
Dns  of  suffering  and  seeking  to  cushion  ourselves  against 
do  we  not  misperceive  and  mismanage  it  in  wa.yr 
hich,  in  the  long  run,  can  only  spell  disaster? 


The  New  Challenge  to  our  Qiurches 
and  Seminaries: 

I.  A  Question  of  Theory*  j 

In  the  preceding  chapters,  attention  has  been  mainlj 
directed  to  the  "crisis'*  in  psychiatry  and  clinical  psy 
chology  which  has  been  occasioned  by  the  pervasiv^ 
acceptance  of  Freudian  psychoanalysis,  with  its  basically 
biological  orientation  and  emphasis.  In  this  chapter  am 
the  immediately  succeeding  ones,  we  now  look,  mon 
explicitly,  at  the  predicament  of  the  churches  and  semi 
naries.  At  prst  slow  to  accept  Freudianism,  they  are  todo) 
displaying  an  astonishing  reluctance  to  let  go  of  it.  Tni 
chapter  gives  some  little-known  facts  about  the  histor} 
of  the  pastoral  counseling  movement  and  shows  how 
after  a  promising  start  in  the  right  direction,  it  was  de 
fleeted  and  distorted  by  psychoanalytic  theory  and  non 
directive  counseling  techniques. 

Initially  written,  by  invitation,  for  a  well  known  re 
ligious  periodical,  this  paper  {and  its  sequel,  see  Chaptei 
7)  was  formally  accepted  and  then  mysteriously  rejected 
Did  the  latter  action  reflect  defensiveness  and  reluctanci 
to  face  up  to  some  unpleasant  facts?  Or  is  there  some 
thing  basically  inaccurate  or  perhaps  unfair  in  the  presem 
analysis?  | 

Has  evangelical  religion  sold  its  birthright  for  a  mes! 
of  psychological  pottage?  In  attempting  to  rectify  theii 
disastrous  early  neglect  of  psychopathology,  have  th< 
churches  and  seminaries  assimilated  a  viewpoint  anc 
value  system  more  destructive  and  deadly  than  the  evi 
they  were  attempting  to  eliminate?  As  a  psychologist 
and  churchman,  I  believe  the  answer  to  these  question; 
is  in  the  afErmative.  If  so,  the  time  is  upon  us  for  i 
searching  reappraisal  and  a  new  plan  of  action. 

But  first  let  me  correct  a  possible  misapprehension 

*  Published  in  Foundations:  A  Baptist  Journal  of  Histor) 
and  Theology,  October,  1960,  3,  335-347. 

60 


lALLENGE  TO  OuR  ChURCHES:    I.   ThEORY  61 

lere  are,  I  know,  some  ministers  and  seminary  profes- 
:s  who  would  be  only  too  happy  to  have  done  with 
s  whole  "clinical  movement."  I  mean  to  give  them  no 
mfort;  for  I  agree  completely  with  Harry  Emerson 
isdick  when  he  says  (in  a  recent  article)  that  earlier  in 
is  century  there  was  in  Protestant  theology  and  pastoral 
ictice  a  gaping  "vacancy"  here  which  urgently  needed 
be  "filled."  The  issue  I  wish  to  discuss  is  not  the 
acancy" — that  has  been  only  too  painfully  real — ^but 
e  question  of  whether  the  way  in  which  it  has  been 
d  is  being  filled  is  sound.  I  do  not  ask  for  less  religious 
ncem  and  effort  for  troubled  persons  but  for  more,  of  a 
ierent  and,  hopefully,  better  kind. 

I. 

In  January  of  1926,  a  then  little-known  man  by  the 
me  of  Anton  T.  Boisen  published  in  Christian  Work 
.  article  which  has  drastically  modified  theological  edu- 
pon  and  changed  church  history.  It  was  entitled  "The 
[lallenge  to  Our  Seminaries,"  and  its  salient  thesis  was 
at  "in  mental  disorders  we  are  dealing  with  a  problem 
liich  is  essentially  spiritual"  (p.  8).  Said  Boisen: 


But  of  any  such  possibilities  the  Church  is  utterly  ob- 
ivious.  She  takes  no  interest  in  cases  of  pronounced  mental 
iisorder.  .  .  .  We  have  therefore  this  truly  remarkable  situa- 
tion— a  Church  which  has  always  been  interested  in  the 
pare  of  the  sick,  confining  her  efforts  to  the  types  of  cases 
physical  illness]  in  which  religion  has  least  concern  and 
east  to  contribute,  while  in  those  types  in  which  it  is  impos- 
;ible  to  tell  where  the  domain  of  the  medical  worker  leaves 
iff  and  that  of  the  religious  worker  begins,  there  the  Church 
s  doing  nothing  (p.  9). 

Since  Fundamentalism  preached  only  a  hell  to  come 
d  liberal  theology  preached  no  hell  at  all,  both,  argued 
tisen,  were  "blind  to  the  hell  which  is  right  before  our 

JS." 

When  we  remember  that  what  we  know  today  about  the 
luman  body  has  come  very  largely  through  the  study  of  dis- 
:ase  conditions,  is  it  any  wonder  that  a  Church  which  has 
0  completely  ignored  the  problem  of  the  soul  that  is  sick, 
s  able  to  speak  with  so  little  authority  concerning  the  laws 
)f  the  spiritual  world?  (p.  10). 


62  The  Crisis  in  Psychiatry  and  Religic 

Boisen's  plea,  therefore,  was  that  the  seminaries  sts; 
sending  their  students  to  mental  hospitals  for  an  "i 
ternship"  of  a  few  months  or  a  year. 

For  we  have  here  a  problem  which  must  be  studied  frc 
real  life  and  not  from  books.  It  is,  moreover,  absolutely 
sential  to  have  the  co-operation  of  medical  men,  for  hci 
the  provinces  of  religious  and  medical  workers  overlap,  a; 
the  medical  worker  is  now  in  possession  of  the  field.  T] 
religious  worker  is  a  mere  beginner,  and  he  must  be  v(J 
careful  not  to  embark  on  any  half-attempt  at  "soul-healini 

(p.  11).  I 

In  this  way  the  young  minister,  upon  leaving  t 
seminary,  would  be  able  to  bring  "a  new  religious  p:^ 
chology"  to  the  people,  so  that  "the  Church  may  od 
more  come  into  its  own  and  speak  no  longer  as  t' 
scribes  and  Pharisees  and  interpreters  of  traditions  l 
with  the  authority  of  the  knowledge  of  the  laws  of  t 
life  that  is  eternal"  (p.  12). 

II. 

The  impact  of  this  article  and  others  of  a  simi 
nature  was  such  that  young  theologians  soon  began  goi 
to  mental  hospitals  for  the  type  of  internship  which  I 
Boisen  recommended;  and  by  1930  the  ''clinical  mo 
ment"  had  gained  sufficient  momentum  to  warrant  1 
formation  of  The  Council  for  Clinical  Pastoral  Traini: 
to  be  followed  in  1944  by  another  organization  cal 
The  Institute  for  Pastoral  Care.  Niebuhr,  Williams,  a 
Gustafson,  in  their  1957  book  on  The  Advancement 
Theological  Education,  comment  upon  these  deveL 
ments  as  follows: 

These  two  programs  have  between  them  initiated  i 
been  responsible  for  a  considerable  part  of  the  clinical  tr; 
ing  of  pastors  for  twenty -five  years.  Many  schools  have  m 
use  of  these  programs  or  devised  similar  ones  (p.  123). 

The  growth  of  this  program  is  shown  by  the  follow 
data.  In  1943  thirteen  seminaries  were  related  to  some  k 
of  clinical  training  program.  Nine  years  later  in  1952  tt 
were  forty- three  schools.  Reports  made  to  the  present  st 
indicate  that  about  three-fourths  of  the  accredited  seminai 
one- third  of  others,  had  either  developed  clinical  trair 
programs  of  their  own  by  1955  or  sent  students  to 
Council  or  Institute  for  such  training  (p.  124). 


HALLENGE   TO  OuR   ChURCHES:    I.   ThEORY  63 

.  .  .  the  close  connection  between  the  traditional  disci- 
pline of  "pastoral  theology"  or  "care  of  soul"  and  the  psy- 
chological approach  to  human  personality  through  first-hand 
experience  of  human  problems  is  widely  recognized  today, 
and  has  given  rise  to  one  of  the  most  influential  movements 
[in  theological  education,  the  emphasis  on  the  preparation  of 
the  Christian  pastor  as  counselor  (p.  122). 

There  is,  of  course,  no  need  to  document  extensively 
e  contrast  between  the  situation  in  1926  and  now  as 
r  as  the  resurgence  of  religious  interest  in  personality 
sturbance  is  concerned;  it  is  immediately  apparent  to 
yone  who  has  been  a  church  member  during  this 
riod,  and  only  a  little  less  so  to  others.  However,  there 
p  signs  of  acute  unrest  and  tension  in  this  area,  both 

the  churches  and  the  seminaries;  and  it  will  be  our 
ijective  in  the  remainder  of  this  article  to  expose  the 
eoretical  issues  here  involved  and,  in  the  sequel  to 
is  discussion,  to  suggest  a  different  practical  approach 

the  whole  problem. 

III. 

Not  only  did  Anton  Boisen,  in  his  early  articles,  show 
e  urgency  of  renewed  religious  interest  in  the  mentally 
;  he  also,  in  1936,  published  a  highly  readable  and 
rceptive  book,  The  Exploration  of  the  Inner  World, 

which  he  outlined  the  theory  of  psychopathology 
lich  he  believed  most  congruent  with  the  great  insights 

religion  and  most  likely  to  lead  to  more  effective 
evention  and  treatment.  Elsewhere  [see  Chapter  2] 
lave  reviewed  Dr.  Boisen's  original  conceptual  scheme 

detail.  Here  a  few  brief  excerpts  from  his  book  will 
tch  the  tenor  of  this  thinking: 

The  form  of  psychotherapy  now  most  in  the  public  eye 
is  psychoanalysis.  This  in  its  aims  is  the  exact  opposite  of 
faith  healing.  It  has  often  been  compared  by  its  proponents 
to  surgery,  and  major  surgery  at  that.  It  is  an  attempt  to 
'  lay  bare  and  bring  into  clear  consciousness  the  disowned  sex- 
ual desires  and  cravings  which  it  assumes  have  become  de- 
tached from  the  conscious  self  and  are  responsible  for  the 
s'  neurotic  symptoms.  Its  aim  is  to  make  over  the  harsh  con- 
*  science  and  the  rigid  ethical  standards  which  have  led  to 
^  the  disowning  of  these  sex  cravings  so  as  to  permit  of  their 
3  incorporation  in  the  personality.  To  this  end  the  psycho- 
analyst tries  to  get  his  patient  to  live  through  again  his 


64  The  Crisis  in  Psychiatry  and  Religiob 

early  experiences.  The  entire  procedure  is  designed  to  detach 
the  patient  from  his  early  loyalties  in  order  to  enable  hiq 
to  build  up  a  new  philosophy  of  life  in  which  the  dissociatec 
cravings  may  be  properly  assimilated  (pp.  243-44). 

In  all  my  efforts  [as  a  hospital  chaplain  and  therapist]  '. 
rely  upon  a  simple  principle  ■  derived  from  my  theologica 
training  which  seems  to  me  far  too  little  understood.  I  refe 
to  the  view  that  the  real  evil  in  mental  disorder  is  not  to  h 
found  in  the  conflict  but  in  the  sense  of  isolation  or  estrange 
ment.  It  is  the  fear  and  guilt  which  result  from  the  presena 
in  one's  life  of  that  which  one  is  afraid  to  tell.  For  this  rea 
son  I  do  not  consider  it  necessary  to  lower  the  consciena 
threshold  in  order  to  get  rid  of  the  conflict.  What  is  neede( 
is  forgiveness  and  restoration  to  the  fellowship  of  that  socia 
something  which  we  call  God  (pp.  267-68). 

I  would  furthermore  [suggest]  that  our  findings  indicafc 
that  the  sense  of  guilt,  the  self-blame  and  the  emotional  dij 
turbance  which  accompany  it  are  not  themselves  evils  bu 
attempts  at  a  cure.  The  real  evil  is  the  failure  to  attain  th 
level  of  adjustment  called  for  in  some  new  period  of  develop 
ment  and  the  short-circuiting  of  the  vital  energies  througl 
easy  satisfaction  (p.  281). 

IV. 

In  retrospect,  we  now  know  that  the  foregoing  wer 
prophetic  words.  But  they  were  not  heeded.  Instead,  th- 
basic  assumption  of  Freudian  psychoanalysis — namel} 
that  psychoneurosis  arises,  not  from  moral  weakness  o 
failure,  but  from  an  excessive  and  irrational  severity  (o 
"disease")  of  the  superego  or  conscience — gradually  pei 
meated  and  possessed  the  pastoral  counseling  movemeni 
One  of  the  earliest  and  most  transparent  indications  o 
this  victory  of  the  Freudian  view,  as  opposed  to  tha 
advocated  by  Boisen,  was  the  appearance  in  1943  o 
Harry  Emerson  Fosdick's  book.  On  Being  a  Real  Persori 
Intended  for  laymen  as  well  as  religious  leaders,  thi 
book  achieved  an  immediate  popularity  and  widespreai 
influence. 

In  a  chapter  entitled  "Handling  Our  IMischievous  Cor 
sciences,"  Fosdick  made  his  position  clear: 

Indiscriminate  praise  of  conscientiousness  is  psycholog 
cally  dangerous.  Many  people  worry  themselves  into  coir 
plete  disintegration  over  moral  trifles,  and  others  have  cor, 
sciences  so  obtuse  that  they  can  get  away  with  anything  (|! 
133).  I 


Challenge  to  Our  Churches:  i.  Theory  65 

Conscience  is  a  tricky  function  of  personal  life  .  .  .  with 
equal  facility  it  makes  saints,  lunatics,  and  bigots  (p.  133). 

Following  one's  conscience  can  be  a  distracting  experience, 
and  numberless  people  are  torn  to  pieces  by  it  (p.  134). 

We  are  supposed  to  sail  by  conscience  and  yet  we  cannot 
trust  it;  instead  of  relying  on  the  compass  to  keep  our 
course  straight,  we  must  keep  our  compass  straight,  and  that 
makes  nervous  sailing  (p.  135). 

Far  from  solving  the  problem  of  conscience,  however,  the 
acceptance  of  it  is  often  only  the  beginning  of  our  difficulty. 
Many  do  accept  their  consciences.  They  are  disastrously  con- 
scientious. .  .  .  The  psychiatrists'  offices  fill  up  with  people 
whose  consciences  are  on  the  warpath,  harassing  them  with 
worry  and  remorse  over  small  scrupulosities  (p.  143). 

The  mischief  is  that  conscience  can  take  advantage  of  its 
importance  and  can  overbid  its  hand.  .  .  .  No  good  can 
come  from  this  plus-activity  of  conscience,  this  hang-over  of 
remorse;  it  spoils  the  life  of  the  sufferer  and  darkens  the 
skies  of  his  family  and  friends.  When  conscience  has  fulfilled 
its  function  it  ought  naturally  to  stop,  but  commonly  it 
persists,  torturing  its  victim  long  after  the  torture  has  lost 
all  value  (p.  147). 

Moralism  deals  with  symptoms  and  condemns  results;  psy- 
chotherapy diagnoses  causes  and  is  concerned  with  cure  (p. 
152). 

Conscience  makes  multitudes  of  people  miserable  to  no 
good  effect  (p.  153). 

That  we  need  more  conscientious  people  is  a  platitude, 
common  but  highly  questionable.  An  immense  amount  of 
conscientiousness  does  more  harm  than  good  (p.  157). 

Although  Dr.  Fosdick  conceded  that  behind  some 
'morbid  conscientiousness"  and  apparent  scrupulosity 
iiere  may  be  real  guilt,  he  stoutly  maintained — and  in 
;o  doing  capitulated  to  the  primal  psychoanalytic  premise 
—that  in  many  other  instances  conscience  is  a  real  mon- 
>ter  which  complains  and  tortures  the  individual  without 
just  cause. 

V. 

In  September  of  1943,  shortly  after  the  publication  of 
On  Being  a  Real  Person^  Dr.  Boisen  wrote  Dr.  Fosdick 
expressing  his  admiration  for  and  appreciation  of  many 
reatures  of  the  book  but  deploring  its  acceptance  of  the 
preudian  doctrine  of  superego  over-severity.  Said  Boisen: 

The  statement  on  page  154  that  the  censorious  con- 
science that  can  be  blighting  when  used  on  others  can  have 


'^ 


66  The  Crisis  in  Psychiatry  and  RELIGIO^ 

a  similar  effect  when  used  on  oneself  is  undoubtedly  true;  nol 
so,  however,  the  statement  on  page  152  that  self-condemna 
tion  is  often  the  most  misleading  fact  that  can  intrude  itself. 
My  observation  is  that  the  patient  who  condemns  himself, 
even  to  the  point  of  thinking  he  has  committed  the  un- 
i  V':  pardonable  sin,  is  likely  to  get  well.  It  is  the  patient  who 
'^     \    blames  others  who  does  not  get  well.  The  one  is  a  benign 
^^3  reaction,  the  other  a  malignant  one.  Self -blame,  even  when 
^^  it  leads  to  severe  psychosis,  means  the  recognition  that  some- 
thing is  wrong  and  the  acceptance  of  one's  responsibility  for 
the  difficulty.  The  emotional  disturbance  which  follows  is; 
then  analogous  to  fever  or  inflammation  in  the  body.  It  is 
not   an    evil    but    a    manifestation    of    nature's    power    to 
heal.  .  .  . 

For  example,  take  the  hypothetical  case  you  describe  on 
page  150.  You  refer  to  the  sense  of  guilt  manifested  by 
this  young  man  as  a  "needless  and  harmful  intruder."  If 
the  young  man  in  question  were  like  most  of  those  I  have 
known,  the  pent-up  volume  of  guilty  fears  would  be  instru- 
mental in  driving  him  to  the  minister's  study  and  the  relief 
he  found  there  would  come  not  so  much  thru  anything  the 
minister  said  to  him  as  from  what  he  said  to  the  minister 
about  a  problem  which  for  him  was  by  no  means  a  minor 
matter. 

I  wish  that  you  might  have  done  more  toward  clarifying 
the  nature  and  function  of  conscience.  Our  psychoanalysts 
have  discovered  it  and  have  much  to  say  about  it,  but  from 
my  point  of  view  their  theories  are  far  from  adequate,  while 
Dewey  and  Mead  and  Hocking  are  not  given  their  rightfuli 
due.  j 

In  an  article  entitled  ''Niebuhr  and  Fosdick  on  Sin,"! 
which  appeared  in  the  Chicago  Seminary  RegisteVj  for! 
March,  1944,  Boisen  repeated  and  elaborated  these  con- 
cerns. However,  he  was  unable  to  stenj  the  tide;  and  the 
Freudian  notion  that  man  sickens,  not  from  sin  but  from 
excessive  conscientiousness,  continued  to  gain  acceptance 
in  theological  circles. 

VI. 

As  already  noted,  there  is  tension  today  in  our  semi- 
naries and  churches  regarding  the  Freud-Fosdick  position; 
but  this  position  is  clearly  in  the  ascendancy,  officially. 
Millions  of  ordinary  church  members  have  never  accepted 
it,  and  many  individual  ministers  and  seminary  teachers 
likewise  deeply  distrust  it.  But  it  has  seemed  that  *'sc]h 


Challenge  to  Our  Churches:  i.  Theory  67 

ence"  was  against  them,  and  they  have  been  reluctant 
to  speak  out  for  fear  of  ''contradicting  science";  whereas 
those  who  beheved  they  were  on  the  side  of  Psychological 
Truth  have  been  boldly  vocal.  Their  outspokenness  could 
be  illustrated  at  great  length;  but  two  recent  examples 
will  suffice.  Dr.  Carl  Michalson,  a  professor  of  theology 
at  Drew  University,  in  the  chapter  on  guilt  in  his  Faith 
for  Personal  Crises  (1959),  writes  as  follows: 

Yes,  the  conscience  (populady  conceived)  is  as  ready  to 
condemn  us  as  our  most  malicious  enemy  would  be.  Our 
conscience  is  a  "prattler,"  bent  less  upon  our  regeneration 
than  upon  our  destruction.  ...  It  is  our  executioner,  bent 
upon  our  destruction,  only  confirming  our  lie  about  ourselves 
and  hiding  from  us  the  truth  that  we  are  in  God's  image, 
made  to  be  responsible  not  to  our  conscience  but  to  Him 
(p.  59). 

Christians  are  often  scandalized  by  psychotherapists  who 
seem  to  relax  the  moral  standard  in  order  to  relieve  the 
tension  of  their  client's  anxious  guilt.  The  psychotherapist  in 
this  instance  is  a  better  interpreter  of  righteousness  than 
many  Christians  are.  .  .  .  Moral  flexibility  may  not  in  itself 
be  healing  but  it  does  less  damage  than  the  tightening  of 
the  demands  which  are  already  cracking  one's  nature.  There 
are  times  when  aspirin  is  more  healing  than  action.  This 
is  the  gospel  truth  in  "the  power  of  positive  thinking" 
(p.  61). 

And  The  Reverend  George  Christian  Anderson,  Direc- 
tor of  the  Academy  of  Religion  and  Mental  Health,  in 
the  first  chapter  of  his  book  Man's  Right  to  he  Human, 
echoes  this  now  familiar  refrain.  He  says: 

Today,  psychiatry  and  the  new  sciences  of  behavior  compel 
us  once  again  to  examine  the  precepts  by  which  we  live, 
shocking  and  enraging  those  whose  houses  were  built  on  the 
foundations  of  their  fathers  (p.  15). 

We  are  now  beginning  to  ask  whether  our  wrongdoing 
is  sin  or  caused  by  emotional  illness.  .  .  .  Health  of  mind 
depends  on  whether  we  can  let  these  forces  ["powerful  needs 
for  love,  raging  hostility,"  p.  19]  come  out  without  feeling 
excessively  guilty  or  frightened  by  what  erupts  from  within 
(p.  17). 

The  psychological  journey  into  our  inner  world  [by  means 
of  psychoanalysis]  helps  us  to  experience  our  emotions 
without  fear,  to  admit  what  we  have  denied,  and  to  deny 
what  we  once  believed.  Psychiatry  obviously  must  reveal  our 


68  The  Crisis  in  Psychiatry  and  Religion 

morals,  and  measure  the  strength  of  the  consequences  of  our 
rehgious  faith  (p.  18). 

VII. 

Quite  aside  from  the  palpable  desertion  of  traditional  : 
Christian  ideals  and  precepts  which  all  such  writings 
represent,  there  is  the  additional — and  not  inconsiderable 
— complication  that  secularists  and  scientists  are  them- 
selves now  busily  re-evaluating  the  whole  Freudian  Weld- 
anschauung. 

In  the  book  first  published  in  German  in  1938  and 
subsequently  (1950)  in  English,  with  the  title  Technique 
of  Analytical  Psychotherapy,  Wilhelm  Stekel,  an  erst- 
while Freudian,  wrote: 

I  contend  that  orthodox  analysis  has  reached  a  crisis 
which  betokens  that  the  end  is  near,  that  collapse  is  ap- 
proaching (p.  xxiv). 

And  after  reviewing  many  case  histories  in  which  it  is 
apparent  that  real  guilt,  rather  than  a  mere  "guilt 
complex,"  was  at  the  basis  of  the  manifest  morbidity, 
Stekel  concluded: 

I  have  had  many  cases  of  the  kind,  but  have  merely 
selected  a  few  to  show  that  parapathic  [neurotic]  disorders 
may  be  diseases  of  the  conscience  [in  a  new  sense].  The 
patient  suppresses  his  remorse,  tries  to  drown  the  voice  of 
conscience,  and  feigns  immunity.  Nature  takes  vengeance 
(p.  327). 

And  more  than  a  decade  ago,  quite  unaware  of  the 
work  of  either  Boisen  or  Stekel,  the  present  writer  (1950) 
was  forced  to  take  the  following  position: 

In  essence,  Freud's  theory  holds  that  anxiety  comes  from 
evil  wishes,  from  acts  which  the  individual  would  commit 
if  he  dared.  The  alternative  view  here  proposed  is  that 
anxiety  comes,  not  from  acts  which  the  individual  would 
commit  but  dares  not,  but  from  acts  which  he  has  com- 
mitted but  wishes  that  he  had  not.  It  is,  in  other  words,  a 
"guilt  theory"  of  anxiety  rather  than  an  "impulse  theory* 
(p.  537). 

What  is  the  situation,  in  psychology  and  psychiatry, 
today?  In  another  connection  [Chapter  1],  I  have  re- 
viewed prevailing  psychiatric  opinion  concerning  psycho- 


Challenge  to  Our  Churches:  i.  Theory  69 

analysis,  typical  of  which  is  the  following  statement  by 
Dr.  Lawrence  Kubie  (1956): 

We  [analysts]  have  no  right  to  be  for  or  against  anything 
in  this  field.  We  have  a  right  only  to  the  most  complete 
humility — humilit}'  that  says  we  still  know  practically  nothing 
about  many  important  elements  in  the  neurotic  process  or 
in  the  psychotherapeutic  process  (p.  103). 

Also  in  1957,  at  its  annual  convention,  the  American 
Psychological  Association,  for  the  first  time  in  its  his- 
tory, sponsored  a  symposium  on  "Religion  and  Mental 
Health";  and  in  September,  1959,  the  same  organization 
lield  a  symposium  on  'The  Place  of  the  Concept  of  Sin 
in  Psychotherapy"  which  attracted  nation-wide  attention 
[Chapter  3]. 

VIII. 

If  theologians  will  take  the  trouble  to  examine  care- 
Fully  what  is  thus  happening  in  the  secular  professions 
and  sciences  on  which  they  have  so  heavily  drawn  for 
their  new  Psychology,  they  will  find  that  something  like 
1  revolution  is  in  progress,  which  leaves  them  clutching 
Freudian  doctrine  to  their  breasts  without  either  biblical 
or  solid  scientific  support  for  it.  The  situation  is  well 
mmmarized  in  a  paper  ("Are  Psychoanalysis  and  Reli- 
gious Counseling  Compatible?")  which  the  New  York 
psychologist,  Lee  R.  Steiner,  read  at  a  meeting  of  the 
Society  for  the  Scientific  Study  of  Religion,  held  in 
November,  1958,  at  Harvard  University: 

It  is  my  impression  from  twenty  years  of  study  of  where 
people  take  their  troubles  and  why  tfiey  seek  out  the  sources 
they  do,^  that  the  ministry  makes  a  tremendous  mistake 
when  it  swaps  what  it  has  for  psychoanalytic  dressing. 
Through  the  ages  the  ministry  has  been  the  force  that  has 
at  least  attempted  to  keep  morality  alive.  It  would  be  a  pity 
if,  in  one  of  the  eras  of  greatest  moral  crisis,  the  clergy 
should  suddenly  abandon  its  strength  for  something  that  has 
no  validity,  no  roots,  and  no  value.  It  is  my  impression  that 
they  would  do  far  better  to  cling  to  what  they  have.  Judaism 
has  endured  for  almost  6,000  years.  Christianity  for  almost 
2,000.  Where  will  psychoanalysis  be  even  25  years  from 
now?  ...  I  predict  that  it  will  take  its  place  along  with 

^  See  Steiner  (1945),  Where  Do  People  Take  Their  Troubles? 


70  The  Crisis  in  Psychiatry  and  Religion 

phrenology  and  mesmerism.  Like  them,  psychoanalysis  was 
the  brain  child  of  a  highly  inventive  scientist,  who  was 
completely  sincere  in  his  belief  that  he  was  opening  up  a 
new  world.  We  shall  respect  Freud  for  his  efforts,  as  we  do 
Gall  and  Mesmer.  Like  them,  Freud  had  the  germ  of  an 
idea  which  flared  into  a  way  of  life  for  a  time,  but  then  i 
vanished.^ 

Today  we  can  no  longer  honestly  accept  Freud  as  the  j 
prophet  which  many  theologians  have  tried  to  make  of  i| 
him.  Instead,  he  is  the  Pied  Piper  who  beguiled  us  into  i| 
serious  misconceptions  and  practices.  In  the  sequel  to- 
this  article,  I  shall  try  to  suggest  ways  in  which  the  j 
churches  and  seminaries  can  recover  lost  ground  in  this  I 
area  and  build  for  a  sounder  future. 

^ Cf .  Dallenbach  (1955). 


i 


The  New  Challenge  to  our  Churches 

and  Seminaries: 

II.  The  Problem  of  Action* 

Here  is  a  preliminary  attempt  to  go  beyond  analysis 
and  become  action-oriented,  to  prescribe  rather  than 
merely  diagnose.  Any  projected  practical  program  always 
has  to  be  tempered  by  circumstances  and  on-going  ex- 
perience, but  the  two  suggestions  made  herein  are  at 
least  promising  beginnings.  A  friend  in  Educational  Ad- 
ministration used  to  be  fond  of  saying  that  action  in  a 
practical  situation  is  never  straight-ahead-according-to- 
blan.  It  is  always  somewhat  opportunistic,  a  slight  advance 
here,  an  unexpected  development  or  opportunity  there. 
But  movement  can  occur  if  there  is  a  clear  goal  and 
steady  pressure  towards  it. 

In  I960  the  World  Council  of  Churches  announced 
a  conference  on  ways  of  revising  and  revitalizing  religious 
worship — a  subject  implementing  the  concerns  expressed 
in  the  following  chapter.  In  March,  1960,  the  ministers 
of  the  First  Community  Church  of  Columbus,  Ohio, 
held  the  first  of  a  projected  series  of  workshops  on  new 
ways  to  use  religion,  in  conjunction  with  psychology  and 
social  science,  to  "remove  blocks  to  personal  growth."  A 
little  later  the  National  Council  of  Churches  held  a  con- 
ference, with  several  secularists  participating,  on  the  place 
of  religion  in  higher  education.  These  developments  are 
representative  of  a  new  ''openness"  to  explore  and  change, 
if  we  can  only  lay  hold  of  a  sound  and  dependable  ra- 
tionale. 

In  Chapter  12  we  shall  go  more  deeply  into  some  of 
the  suggestions  which  are  made  in  this  chapter  {see  also 
Chapter  S). 

In  Part  I  of  this  article  [Chapter  6],  I  have  traced  the 
brief  history  of  the  pastoral  counseling  movement  and 

*  Published  in  Foundations:  A  Baptist  Journal  of  History 
and  Theology,  October,  1960,  3,  335-347. 

71 


72  The  Crisis  in  Psychiatry  and  Religion 

have  shown  it  to  have  had  four  stages:  (1)  that  of  grow- 
ing awareness  (on  the  part  of  Boisen,  Fosdick,  and 
others)  of  the  failure  of  early  20th-century  religion  to 
speak  and  minister  to  man's  psychological  and  emotional 
needs;  (2)  the  initiation  of  the  pastoral-counseling,  or 
"clinical,"  movement  (largely  through  the  work  of 
Boisen  and  his  students)  and  Boisen's  efforts,  epitomized 
in  his  1936  book,  The  Exploration  of  the  Inner  World, 
to  give  this  movement  a  conceptual  framework  which 
would  be  congruent  with  the  traditional  Judeo-Christian 
ethic;  (3)  the  blighting  of  this  aim  by  the  intrusion  of 
the  Freudian  doctrine  that  human  beings  sicken  in  mind 
and  soul,  not  from  sin,  but  from  their  very  excess  of 
piety  (or  "moralism");  and  (4)  current  developments 
in  the  sciences  and  secular  professions  which  are  casting 
grave  doubt  upon  the  validity  of  the  Freudian  view  and 
thus  placing  many  contemporary  clergymen  and  semi- 
narians in  the  awkward  position  of  having  "sold  their 
birthright." 

It  now  appears  that  Boisen  was  right,  that  psycho- 
pathology  is  a  moral  problem,  through  and  through,  and 
that  it  has  gravitated  into  medical  hands  by  default  and 
complacency  on  the  part  of  the  Christian  ministry  and 
churches.  Recently  a  church  woman  in  Massachusetts 
wrote  me  a  letter  which  she  concluded  by  saying,  "Cer- 
tainly if  these  ideas  gain  general  acceptance,  psycho- 
therapy would  be  revolutionized."  On  the  assumption, 
substantiated  in  the  earlier  article,  that  these  ideas  are 
"gaining  acceptance,"  we  shall  here  explore  some  of 
the  implications  which  follow  for  courses  of  action 
which  our  churches  and  seminaries  can  pertinently  con- 
sider and,  hopefully,  pursue. 

I. 

In  the  preceding  article,  I  have  called  attention  to 
Dr.  Boisen's  1926  article,  "The  Challenge  to  Our  Semi- 
naries," in  which  he  urged  seminary  students  to  do  an 
internship  in  a  mental  hospital  in  order  that  they  might 
bring  "a  new  religious  psychology"  to  the  people  and 
that  "the  Church  may  once  more  come  into  its  own  and 
speak  no  longer  as  the  scribes  and  Pharisees  and  inter- 
preters of  traditions  but  with  authority  of  the  knowledge 
of  the  laws  of  the  life  that  is  eternal"  (p.  12).  And  I 
also  cited  the  recent  Niebuhr-Williams-Gustafson  report 


Challenge  to  Our  Churches  il  Action  73 

on  The  Advancement  of  Theological  Education  to  show 
how  widely  this  admonition  is  now  being  followed.  But 
this  new  "clinical"  program  has  been  deflected  from  the 
course  Dr.  Boisen  originally  conceived  for  it  and  has 
taken  on  a  strongly  Freudian  and  neo-Freudian  colora- 
tion. This,  quite  understandably,  has  created  an  uneasi- 
ness in  our  seminaries,  which,  however,  has  remained 
muted  and  is  only  now  beginning  to  come  out  into  the 
open.  For  example,  in  the  report  just  cited,  the  authors 
guardedly  say: 

Firsthand  experience  with  persons  in  trouble  is  the  basic 
material  out  of  which  Christian  skill  in  care  of  souls  must 
come.  .  .  .  Yet  in  spite  of  the  ease  with  which  this  field 
can  lead  out  and  away  from  its  theological  center,  there  is 
a  strong  determination  in  the  schools  to  keep  the  psycho- 
logical approach  to  personality  in  close  relation  to  the 
Church  and  its  faith.  There  is  indeed  considerable  tension 
within  some  schools  on  the  place  of  this  field  in  the  cur- 
riculum  (p.  122,  italics  added). 

Clinical  training  programs  need  the  schools  not  only  for 
students  and  financial  support  but  also  as  a  source  of  con- 
structive criticism  (p.  125,  italics  added). 

The  pitfall  is  that  [the  student]  may  begin  to  "psycholo- 
gize" everything  and  try  to  solve  every  problem  of  faith 
through  psychological  analysis  (p.  127). 

II. 

The  present  situation  is,  I  believe,  a  very  serious  one 
and  far  from  what  Dr.  Boisen  originally  intended.  During 
the  clinical  internship  and  in  propaedeutic  seminary 
courses,  students  are  typically  schooled  in  the  view  that 
psychopathology  is  only  indirectly  a  religious  concern. 
They  are  deeply  indoctrinated  with  the  view  that  neu- 
rosis and  psychosis  arise  from  too  much  ''morality," 
rather  than  too  little,  and  that  the  minister  must  care- 
fully recognize  his  "limitations"  in  dealing  with  such 
problems. 

The  total  impact  of  this  experience  has,  it  seems,  not 
been  a  good  one.  Typically,  the  student  returns  to  semi- 
nary either  confused,  by  the  manifest  contradictions 
between  his  religious  heritage  and  psychological  and 
psychiatric  doctrines,  or  with  the  feeling  that  here,  in 
psychiatry  and  psychology,  is  a  redemptive  ("therapeu- 
tic") power  exceeding  anything  that  religion  itself  can 
offer.  The  result  is  that  if  and  when  the  seminarian,  as 


74  The  Crisis  in  Psychiatry  and  Religion 

parish  minister,  later  undertakes  pastoral  counseling,  it  is 
with  the  feeling  that  his  ''psychological  methods"  are 
something  apart  from  his  theology  and  Christian  faith 
and  that  he  can,  at  best,  deal  only  with  persons  whose 
difficulties  are  relatively  superficial.  He  is  carefully  in- 
structed, both  by  members  of  the  secular  healing  profes- 
sions and  by  his  own  supervisors,  on  the  importance  of 
''knowing  when  to  refer."  In  his  own  eyes  as  well  as  those 
of  others,  he  is  clearly  a  second-  or  third-class  operator 
in  this  field;  and  even  Niebuhr,  Williams,  and  Gustafson 
bow  to  this  prevailing  state  of  affairs,  when  they  say: 

We  must  add  the  warning  that  the  student  needs  to 
learn  the  kinds  of  problems  which  require  medical  attention 
and  which  as  pastor  he  should  not  try  to  handle.  His  minis- 
try is  to  the  person  in  his  religious  need  (p.  128). 

Has  this  type  of  program  indeed  taught  our  clergy  to 
speak  with  authority,  or  as  the  scribes  and  Pharisees?  ^ 

III. 

How  ingrained  the  "psychiatric"  view  has  become  in 
the  minds  of  many  of  our  clergymen  is  reflected,  with 
special  clarity,  in  Anderson's  recent  book  (also  cited  in 
the  preceding  article)  entitled  Man's  Right  to  Be  Hu- 
man, with  the  equivocal  subtitle.  To  Have  Emotions 
Without  Fear.  Here  the  stock  position  is  reiterated,  thati 
the  psychologist,  psychiatrist,  psychoanalyst,  social  worker  | 
— indeed,  almost  anyone — is  better  equipped  to  deal  with 
serious  emotional  problems  than  is  the  minister.  If,  as 
we  now  have  reason  to  believe,  all  psychopathology  (of 
the  functional  varieties)  stems  from  moral  failure,  how 
fantastic  all  this  is!  And  yet  many  ministers  have  what 
may  be  termed  a  "trained  incapacity"  and  educated 
reluctance  to  really  come  to  grips  with  the  problem  of 
mental  illness.  Instead,  they  dutifully  "refer,"  as  indicated 
in  the  following  excerpts  from  the  book  just  cited: 

It  was  evident  that  Joe  was  suffering  from  a  serious 
neurosis.  As  soon  as  Joe  was  gone  I  picked  up  the  phone 

^  In  an  attempt  to  escape  the  pall  of  psychological  and 
medical  domination  in  this  area,  there  is  now  a  tendency  on 
the  part  of  some  writers  to  speak  of  Pastoral  Theology,  rather 
than  of  Pastoral  Psychology  or  Pastoral  Psychiatry.  But  it  is 
doubtful  if  a  theological  emphasis  is  so  much  what  is  needed 
as  a  sounder,  more  defensible  psychological  one,  although  it 
is  realized  that  a  valid  absolute  distinction  here  is  not  possible. 


Challenge  to  Our  Churches  n.  Action  75 

and  called  a  psychiatrist  I  knew  and  explained  the  situation. 
He  agreed  to  see  Joe  the  next  day.  ...  I  was  able  to  make 
her  [Joe's  sister,  with  whom  he  lived]  see  that  Joe  was  not 
as  immoral  as  he  was  sick,  and  that  he  needed  love  and  under- 
standing, and  medical  care,  too,  more  than  ever  (p.  141). 

''Most  men  are  beasts;  only  my  Lord  in  heaven  is  worthy 
of  my  purity,"  she  continued.  I  suggested  that  she  come 
see  me  again,  but  in  the  meantime  I  referred  her  to  a 
clinical  psychologist  for  some  vocational  tests.  ...  It  was 
obvious  that  the  young  woman  was  handicapped  by  a  severe 
neurosis  involving  excessive  guilt  concerning  her  sexual  feel- 
ings. Inasmuch  as  psychotherapy  was  indicated,  the  girl  was 
referred  to  a  psychiatrist  who  was  able  to  help  her  accept 
her  sexuality  in  a  healthy  manner   (p.  172). 

A  man  came  to  see  me  about  his  wife's  growing  coolness 
toward  him.  .  .  .  After  counseling  with  both  of  them  in- 
dividually, I  discovered  that  the  wife  really  loved  her  husband 
very  deeply  even  though  she  abhorred  his  sexual  claims.  I 
referred  both  of  them  to  a  psychiatrist  for  further  profes- 
sional help  (p.  176). 

This  is  typical  of  what  is  supposed  to  be  "good  prac- 
tice" in  the  ministry  today.  And  not  long  ago  a  young 
clergyman  who  had  just  come  to  our  community  informed 
me  that  he  had  been  advised,  in  seminary,  not  only  to 
be  sure  to  "know  when  to  refer"  but  also  to  be  very 
careful  in  his  sermons  not  to  say  anything  that  would 
make  anyone  "feel  guilty."  People  have  too  much  guilt 
already,  he  had  been  told;  and  if  you  talk  about  sin  and 
guilt  and  moral  responsibility  from  the  pulpit,  you  only 
increase  the  danger  of  "neurosis."  I  wonder  if  this  young 
man's  professors  know  these  lines  from  page  109  of  T.  S. 
Eliot's  play,  The  Elder  Statesman: 

You  think  that  I  suffer  from  a  morbid  conscience, 
From  brooding  over  faults  I  might  well  have  forgotten. 
You  think  that  I'm  sickening,  when  I'm  just  recovering! 


IV. 

What  the  average  theologian  and  religious  worker  ap- 
parently does  not  know  and  is  reluctant  to  recognize  is 
the  extent  to  which  the  system  of  concepts  and  practices 
in  which  he  has  been  schooled,  during  his  training  in 
pastoral  psychology,  is  today  in  a  state  of  deterioration 
and  impending  collapse.  From  the  standpoint  of  those 
of  us  who  know  these  developments  from  the  inside. 


76  The  Crisis  in  Psychiatry  and  Religion 

it  is  tragic  to  see  the  clergy  continue  to  pay  homage  to 
what,  in  reahty,  is  rapidly  becoming  a  hollow  shibboleth.  I 
For  more  than  a  decade,  now,  I  have  been  pointing  to 
the  logical  and  empirical  incongruities  in  psychoanalytic 
theory,  on  which  so  much  psychiatry  and  clinical  psy- 
chology is  directly  or  indirectly  founded;  and  in  addition 
to  my  already  published  books  and  articles  in  this  field, 
I  invite  the  reader's  attention  to  various  reprints  and 
mimeographed  papers  which  will  be  supplied  upon  re- 
quest [now  assembled  as  the  chapters  of  this  book]. 

But  in  these  misgivings  concerning  psychoanalysis  and  ' 
the  sense  of  untapped  potential  within  the  great  tradi- 
tions and  insights  of  religion  itself,  I  am  by  no  means 
alone,  as  has  been  indicated  in  the  preceding  article. 
And  to  that  line  of  evidence  I  wish  now  to  add  further  ' 
testimony  of  failure  on  the  part  of  that  profession  in  I 
which  theologians  have  placed  such  supreme  faith.  Re-^l 
cently  I  was  talking  to  a  supervising  psychologist  in  the  I 
Veterans  Administration  who  expressed  the  most  pro- ! 
found  disillusionment  with  prevailing  psychotherapeutic 
methods  and  referred  to  VA  mental  hospitals  as  "sick 
institutions."  And  Dr.  H.  C.  Solomon  had  this  to  say 
in  the  1958  presidential  address  to  the  American  Psy- 
chiatric Association: 

Large  mental  hospitals  are  antiquated,  outmoded,  and 
rapidly  becoming  obsolete.  We  can  still  build  them  but  we 
cannot  staff  them;  and  therefore  we  cannot  make  true  hos- 
pitals of  them.  ...  I  do  not  see  how  any  reasonably  objec- 
tive view  of  our  mental  hospitals  today  can  fail  to  conclude 
that  they  are  bankrupt  beyond  remedy.  I  believe  therefore 
that  our  large  mental  hospitals  should  be  liquidated  as 
rapidly  as  can  be  done  in  an  orderly  and  progressive  fashion 

If  my  description  is  correct  and  my  projections  reasonably 
accurate,  a  new  attack  on  the  "care  and  custody"  of  the 
long-term  ill  must  be  attempted.  Unpalatable  as  it  may 
appear,  one  must  face  the  fact  that  we  are  doing  little  by 
way  of  definite  treatment  of  a  large  number  of  our  chronic 
hospital  population.  It  is  not  even  the  case  that  we  are 
providing  them  with  first-class  environmental  care,  much  less 
loving  and  tender  care.  Therefore,  I  suggest  we  take  a  new 
look  at  the  problem  (p.  8). 

Somewhat   parenthetically   and   without   elaboration, 
Dr.  Solomon  observes: 


Challenge  to  Our  Churches  ii.  Action  77 

Our  young  physicians  specializing  in  psychiatry  are  not 
heading  toward  our  large  hospitals,  nor  are  the  other  cate- 
gories of  personnel.  In  many  of  our  hospitals  about  the  best 
that  can  be  done  is  to  give  a  physical  examination  and  make 
a  mental  note  on  each  patient  once  a  year,  and  often  there 
is  not  even  enough  staff  to  do  this  much  (p.  7). 

Despite  government-sponsored  subventions  and  schol- 
arships, the  men  and  women  who  are  today  being  trained 
in  psychiatry  are  not  going  into  state  and  VA  mental 
hospitals  for  one  major  reason.  It  is  not  that  the  need 
is  not  great;  they  can  make  more  money  in  private 
practice!  There  are,  to  be  sure,  some  dedicated  and 
idealistic  psychiatrists  and  clinical  psychologists.  But  the 
plain  fact  is  that  professional  psychotherapy  is,  in  general, 
iJ  business;  and  if  it  turns  out  that  what  the  patient 
jjecretly  hopes  to  buy  (and  the  therapist  implicitly  prom- 
ises to  sell)  is  a  cheap  form  of  forgiveness  and  expiation 
![cf.  Chapter  10],  the  "therapeutic"  transaction  is  a  very 
dubious  business^as  Katie  Lee  slyly  implies  when  she 
ings  (in  "Shrinker  Man"): 

I've  been  on  one  of  those  "complex"  tours; 
I  want  you  to  make  my  problems  yours. 
Now  gimmie  one  of  them  cut-rate  cures, 
Shrinker  Man! 

Can  an  enterprise  that  thus  measures  in  dollars  and 
-ents  its  efforts  to  minister  to  sick  minds  and  souls 
continue  indefinitely  to  command  our  respect  and  con- 
idence? 

V. 

If  we  have  now  accurately  diagnosed  the  difficulty, 
vhat's  to  be  done  about  it?  In  the  over-all  and  ultimate 
;ense,  I  have  to  say  that  I  do  not  know.  Certainly  the 
otal  situation  calls  for  courage,  social  inventiveness,  and 
nsights  which  I  do  not  possess.  But  I  do  have  two  sug- 
jestions  to  make. 

I  think  we  now  have  to  recognize  that  Protestantism 
las,  on  the  whole,  handled  the  problem  of  guilt  very 
)adly  and  that  the  present  critical  situation  is  a  natural 
;ulmination  of  four  centuries  of  bumbling,  indecision, 
.nd  confusion  on  this  score.  As  a  first  step,  therefore, 
oward  rectifying  our  predicament,  I  believe  our  churches 


78  The  Crisis  in  Psychiatry  and  Religion 

ought,  as  Harry  Emerson  Fosdick  argued  (somewhat 
inconsistently)  as  early  as  1927,  to  return  to  the  practice 
of  confession.  We  have  tried  to  ignore  and  by-pass  the 
very  notion  of  guilt  and  sin;  but  it  won't  work.  The 
gospel  of  sin  and  salvation  (redemption)  is  not  one  of 
bondage  but  of  liberation,  hope,  and  strength;  and  we 
must,  I  believe,  return  to  it  in  all  seriousness. 

Pastoral  counseling,  as  presently  practiced,  is,  to  be 
sure,  itself  a  form  of  "confession,"  but  it  has  two  major 
weaknesses:  (1)  it  is  episodic,  voluntary,  and  often 
belated  and  therefore  lacks  the  preventive  function  which 
regular,  prescribed  confession  (when  practiced  con-i 
scientiously  and  earnestly)  has;  and  (2)  "counseling" 
is  now  very  largely  patterned  on  secular  psychotherapy,, 
with  its  emphasis  on  "acceptance"  and  "insight,"  and 
does  not  take  sin  really  seriously.  People  do  not  merely, 
"talk"  themselves  into  sin;  they  act.  And  by  the  same| 
token,  I  do  not  believe  anyone  ever  talks  himself  out 
of  sin.  Again  there  must  be  action,  and  this  action  musti 
involve  not  only  confession,  of  an  ultimately  open  type, 
but  also  "atonement."  Confession  without  a  sober  pro- 
gram of  expiation  can  be  dangerous,  in  the  sense  oi 
causing  the  individual  to  be  overwhelmed  with  guilt  andj 
self-hatred.  And  this  is  one  of  the  unrecognized  factors! 
that  makes  many  present-day  religious  counselors  soi 
insecure  and  unconfident.  But  if  we  can  only  understand! 
man's  true  "condition,"  ways  will  be  found  to  overcome 
the  apparent  obstacles  [see  later  chapters].  | 

VI. 

My  other  suggestion  has  to  do  with  a  possible  change 
in  emphasis  in  the  "missionary"  concern  of  our  churches 
and  the  problem  of  staffing  our  state  mental  hospitals, 
which  has  already  been  alluded  to. 

The  legal  and  social  climate  being  what  it  is  at  present, 
clergymen  are  justifiably  afraid  to  try  to  go  "all  the 
way"  with  emotionally  disturbed  persons.  Sometimes 
it  is  virtually  inevitable  that  an  individual  pass  through  a 
psychotic  interlude  (for  reasons  already  mentioned)  on 
his  way  to  personal  transformation  and  recovery.  It  is, 
of  course,  not  uncommon  for  psychiatrists  themselves  tc 
have  in  treatment  patients  whom  they  eventually  have 
to  commit  to  mental  hospitals.  But  if  a  person  is  seeing 


[Challenge  to  Our  Churches  n.  Action  79 

1  religious  counselor  and  becomes  actively  psychotic,  the 
:ounselor  is  immediately  vulnerable.  He  made  the  person 
^orse;  he  should  have  referred  the  patient;  etc.,  etc. 

In  an  attempt  to  find  a  solution  to  this  intolerable 
)ituation,  a  few  denominations  are  experimenting  with 
nental  hospitals  of  their  own.  Without  state  support, 
these  are,  of  course,  extremely  expensive  to  operate;  and 
)uch  reports  as  I  presently  have  indicate  that  even  these 
institutions  rather  pride  themselves  on  the  fact  that  they 
ire  conducted  along  "approved  psychiatric  lines,"  rather 
than  with  any  great  new  insight  born  of  religious  precept 
md  conviction. 

Alternatively,  I  would  like  to  see  our  chu'-^hes  take 
mental  hospitals  as  a  major  object  of  missionary  effort. 
[sn't  it  a  little  awkward  for  us  to  be  so  concerned  about 
the  benighted  state  of  those  in  foreign  lands  when  the 
size  and  condition  of  our  "insane  asylums"  stand  out 
like  great  festering  sores  on  the  conscience  of  our  own 
nation?  I  know  a  state  mental  hospital  (not  atypical) 
with,  a  population  of  4500  patients  without  a  single 
trained  psychiatrist  on  the  staff.  Such  physicians  as  there 
are,  are  immigrants  or  have  for  some  other  reason  com- 
monly failed  to  obtain  a  state  license  for  general  medical 
practice.  And  there  is  one  Protestant  chaplain  and  one 
Catholic  priest  for  this  "town,"  where  the  religious  and 
spiritual  needs  are  surely  far  greater  than  in  a  normal 
community  of  comparable  size. 

So  why  not  let  the  churches  also  start  at  the  other 
end  of  the  line,  with  persons  who  have  already  hit  bot- 
tom; who  are  in  a  protected  environment,  where  the 
only  direction  they  can  move  is  up?  Here  the  religious 
worker  can  be  associated  with  a  person's  rise,  rather  than 
his  fall.  And  imagine  the  gratitude,  loyalty,  and  enthu- 
siasm which  would  be  generated  in  persons  who  felt  that 
religious  insights  and  practices  had  saved  them  from  the 
hell  of  mental  illness! 

Elsewhere  [Chapter  2]  I  have  argued,  with  Boisen, 
that  in  neurosis  and  psychosis  the  afflicted  individual  is 
in  a  moral  and  spiritual  crisis,  and  that  in  no  other 
circumstances  does  the  experience  of  God  become  such 
a  vivid  reality.  (See  also  Frederick  West's  book.  Light 
beyond  Shadows!)  But  the  common  perception  is  that 
so-called  mental  "illness"   really  is   an  illness  and  has 


80  The  Crisis  in  Psychiatry  and  ReligionI 

nothing  to  do  with  either  God  or  the  Devil.  Is  this 
progress  or  one  of  the  greatest  popular  fallacies  of  all 
time?  Can  it  be  that  we  have  come  to  doubt  the  very 
existence  of  Cod  because  we  do  not  know  where  to 
look  for  Him  and  how  to  recognize  His  most  tangible 
manifestations?  ^  If  churches  today  made  a  determined 
effort  to  come  to  grips  with  the  problem  of  mental  illness 
in  this  country,  they  could  not  only  perform  a  great 
human  service;  they  would  also,  I  predict,  discover  a  new 
and  vitalizing  force  which  will  forever  elude  them  at  the 
more  superficial  levels  of  religious  ritual  and  observance. 
As  a  friend  of  mine,  who  is  a  psychiatrist  but  also  ac- 
tively religious,  recently  remarked,  "Unless  you  face  the 
demons,  you  never  hear  the  angels!" 

^Cf.  Robinson  (1928). 


i 


8 


Psychopathology  and  the  Problem 
of  Guilt,  Confession,  and  Expiation* 

If  any  one  chapter  is  nuclear  to  this  book  as  a  whole, 
it  is  the  present  one.  Here  we  come  to  grips,  empirically , 
with  the  question:  Does  psychopathology  involve  real 
or  only  "imaginary"  guilt?  If  the  psychoneurotic' s  guilt  is 
not  real,  the  whole  argument  collapses.  If  it  is,  then  the 
necessity  for  a  long  and  complicated  series  of  ideological 
and  institutional  changes  weighs  heavily  upon  us. 

Some  readers,  upon  completing  this  chapter,  may  feel 
dissatisfied  at  the  absence  of  any  effort  to  provide  a 
formal  definition  of  ''real"  guilt,  sin,  evil.  Concern  with 
this  problem  will  come  in  due  course.  But  what  is  more 
immediately  important,  it  seems,  is  to  get  some  feel  for 
the  raw  data.  Without  a  strong  sense  of  the  pragmatic 
and  factual,  definition  making  can  be  both  tedious  and 
sterile. 

The  case  material  and  other  clinical  evidence  here 
cited  is  not,  of  course,  submitted  as  definitive  ''proof" 
of  a  universal  or  absolute  principle  but  only  as  illustrative 
of  a  possibility.  Already  there  is  a  decided  inclination  to 
concede  that  real  guilt  can  be  determinative  in  person- 
ality disorder.  The  question  is  whether  it  always  is.  The 
present  writer  is  entirely  willing  to  leave  the  answer  to 
this  question  open,  pending  further  research  and  expe- 
rience. But  even  if  guilt  is  real  {rather  than  illusory) 
in  only  half  or  a  third  of  all  personality  disturbances,  it 
still   constitutes  an  enormous  practical  problem,  with 

*  In  addition  to  serving  as  the  first  of  the  E.  T.  Earl  Lectures 
at  the  1960  Pastoral  Conference  sponsored  by  the  Pacific 
School  of  Religion,  February  23-25,  in  Berkeley,  California, 
this  paper  was  read  before  the  St.  Louis  Society  of  Neurology 
and  Psychiatry,  April  1,  1958,  and  at  the  Symposium  on 
Current  Trends  in  Psychology  held  by  the  University  of  Pitts- 
burgh, March  12-13,  1959.  It  has  also  been  pubhshed  ir» 
Current  Trends  in  Psychology,  X,  University  of  Pittsburgh 
Press,  1960. 

81 


82  The  Crisis  in  Psychiatry  and  Religion 

which  neither  the  churches  nor  secular  professions  are 
presently  dealing  at  all  adequately.  And  if  it  should 
turn  out  that  real  guilt  {however  disguised  or  displaced) 
is  the  chief  etiological  factor  in  all  psychopathology^  the 
situation  will  be  still  more  disconcerting  and  challenging. 

Historically  the  prevailing  view,  in  literature  and  non- 
literate  societies  alike,  has  been  that  man  sickens  in 
mind,  soul,  and  perhaps  even  body  because  of  unconfessed 
and  unatoned  real  guilt — or,  quite  simply,  from  what 
an  earlier  era  knew  as  a  state  of  ''disgrace"  or  "sin." 
However,  as  a  result  of  complicated  historical  reasons 
which  have  been  explored  elsewhere  [Chapters  9  and  11], 
this  view  has,  in  our  time,  fallen  into  disrepute.  The 
church,  badly  weakened  by  internal  strife  and  injudicious 
opposition  to  science,  quietly  relinquished  its  traditional 
claim  to  competence  in  the  domain  of  the  sick  soul  and 
unprotestingly  accepted  the  emphasis  of  19th-century 
psychiatry  on  constitutional  and  biochemical  factors. 

It  was,  therefore,  in  this  remarkable  setting  that 
psychoanalysis  had  its  inception  and  rapid  growth.  As 
Freud  observed  in  his  autobiography  (1935),  toward  the 
end  of  the  last  century  there  were,  in  every  large  European 
city,  "crowds  of  neurotics,  whose  number  seemed  further 
multiplied  by  the  manner  in  which  they  hurried,  with 
their  troubles  unsolved,  from  one  physician  to  another" 
(p.  27).  The  church  had,  in  effect,  turned  a  deaf  ear  to 
the  needs  of  these  people;  and  the  common  forms  of 
medical  and  psychiatric  treatment,  which  were  predicated 
on  a  somatic  conception  of  personality  disorder,  were 
I  magnificently  ineffective.  The  situation  thus  called  for  a 
'  boldness  which  Freud  supplied  in  the  form  of  a  clever 
compromise  between  the  traditional  moral  view  of  per- 
sonality disturbance  and  medical  preconceptions.  Cuilt, 
he  hypothesized,  was  indeed  a  factor  in  neurosis  but  it 
was  a  false,  unrealistic,  and  crippling  guilt  which,  as  a  , 
result  of  a  too  strict  and  restricting  socialization  of  the 
individual,  impeded  the  normal  flow  of  certain  instinctual 
energies,  notably  those  of  sex  and  aggression.  So  the 
psychoanalytic  physician  set  out  to  cure  neurotic  individ- 
uals by  championing  the  rights  of  the  body  in  opposition 
to  a  society  and  moral  order  which  were  presumed  to  be 
unduly  harsh  and  arbitrary. 


Guilt,  Confession,  and  Expiation  83 

There  was,  of  course,  no  lack  of  individuals  who  were 
willing  to  be  saved  by  this  plausible-sounding  and  pleas- 
ant philosophy — and  who  were  willing  to  pay  for  it, 
handsomely.  Thus,  both  patients  and  practitioners  of  the 
art  were  assured.  But  the  day  of  reckoning  is  upon  us. 
Our  mental  hospitals  are  now,  alas,  full  of  persons  who 
have  had  this  new  form  of  treatment  and  not  profited 
from  it;  and  among  them,  their  erstwhile  therapists,  and 
the  general  public  alike  there  is  growing  disillusionment 
and  alarm.  Once  again  we  are  in  a  period  of  sober  reap- 
praisal; and  it  is  the  purpose  of  this  paper  to  suggest 
one  way  of  re-thinking  the  problem  which,  although  in 
some  respects  very  costly,  nevertheless  promises  a  form 
of  redemption  more  radical  and  generally  applicable  than 
anything  we  have  known  in  the  recent  past. 

As  the  title  of  this  paper  implies,  it  will  be  our  plan 
to  consider,  first,  the  possibility  that  in  psychopathology 
guilt  is  real  rather  than  illusory  ("delusional");  then  we 
shall  explore  the  correlative  proposition  that  the  aim  of 
communication  and  self-disclosure  in  the  therapeutic  sit- 
uation is  not  mere  understanding  and  insight  (in  the 
Freudian  sense  of  these  terms)  but  a  changed,  repentant 
view  of  oneself;  and  finally  we  shall  examine  evidence 
for  believing  that,  however  necessary  they  may  be,  con- 
trition and  confession  are  not  alone  enough  to  restore 
psychic  and  moral  equilibrium  and  must  be  followed  by 
meaningful,  active  forms  of  atonement  or  restitution. 

I.  HOW  REAL   IS  THE  NEUROTICUS  GUILT? — 
A  QUESTION  OF   FACT 

Freud  held  that,  as  a  result  of  a  too  intensive  socializa- 
tion, some  individuals  develop  so  great  a  fear  of  their 
sexual  and  hostile  feelings  that,  eventually,  they  even 
deny  these  feelings  access  to  consciousness  and  that  it  is 
the  alarm  which  the  ego  feels  when  these  impulses  clamor 
for  recognition  and  expression  (i.e.,  the  danger,  as  Freud 
called  it,  of  the  ''return  of  the  repressed")  that  generates 
the  characteristic  neurotic  affects  of  depression,  anxiety, 
and  panic.  In  1950  the  present  writer  (see  Chapters 
18-22)  hypothesized  that  in  neurosis  it  is  actually  the 
individual's  conscience  that  has  been  repudiated  and 
"repressed"  rather  than  his  "instincts,"  thus  shifting  the 


84  The  Crisis  in  Psychiatry  and  Religion 

emphasis  from  Freud's  impulse  theory  of  neurosis  to  a 
guilt  theory.  Actually,  as  is  now  evident,  this  position  had 
been  anticipated  by  Runestam  (1932),  Boisen  (1936), 
and  Stekel  (1938),  and  it  now  seems  to  be  steadily 
gaining  in  acceptance.  However,  the  doctrine  of  repres- 
sion, upon  which  the  difference  in  opinion  here  hinges, 
is  a  subtle  one  and  not  easily  amenable  to  objective 
verification,  so  the  issue  has  remained  a  debatable  one 
[see  Chapter  2]. 

But  there  is  another  way  of  putting  the  problem  which 
makes  it  more  immediately  researchable.  According  to 
Freud  and  his  followers,  the  neurotic  is  in  trouble,  not 
because  of  anything  actually  wrong  which  he  has  doney 
but  merely  because  of  things  he  would  like  to  do  but, 
quite  unrealistically,  is  afraid  to.  By  contrast,  the  other 
view  is  that  in  neurosis  (and  functional  psychosis),  the 
individual  has  committed  tangible  misdeeds,  which  have 
remained  unacknowledged  and  unredeemed  and  that  his 
anxieties  thus  have  a  realistic  social  basis  and  justification. 

So  conceived,  the  difference  between  the  two  positions 
can  be  empirically  studied  with  soirie  precision.  Accord- 
ing to  the  Freudian  view,  the  neurotic  should  have  a 
history  of  something  like  saintliness;  whereas,  according 
to  the  other  position,  he  should  have  a  record  (albeit 
a  carefully  concealed  one)  of  actual  and  incontestable 
misconduct  and  perversity.  This  issue  should  by  all  means 
be  submitted  to  systematic  investigation  on  a  scale  cor- 
responding to  its  significance.  But  I  confess  that,  for 
myself,  I  am  already  pretty  well  persuaded  what  the 
results  would  be  and  will  here  merely  cite  a  few  examples 
of  the  kinds  of  evidence  which  is  already  widely  available 
on  this  score  and  which  I,  personally,  find  convincing. 

In  the  summer  of  1956,  a  manuscript  was  transmitted 
to  me  which  has  now  been  published  in  the  Journal  of 
Abnormal  and  Social  Psychology  (Anonymous,  1958), 
for  which  I  wrote  the  following  brief  introduction.  The 
paper,  I  should  say,  is  entitled  "A  New  Theory  of  Schizo- 
phrenia." 

This  remarkable  paper  was  written  some  two  years  ago 
by  a  then  34-year-old  man  residing  in  a  closed  ward  in  one 
of  our  large  VA  hospitals  with  a  diagnosis  of  "paranoid 
schizophrenia."    Soon    after   the   original   manuscript   came 

I 


Guilt,  Confession,  and  Expiation  85 

into  my  hands  (through  a  former  student),  I  had  it  mimeo- 
graphed and,  in  the  interim,  as  occasion  arose,  have  obtained 
reactions  thereto  from  several  chnical  psychologists,  psy- 
chiatrists, and  theologians.  The  evaluations  fall  into  two 
categories:  some  hold  that  the  paper  is  just  what  it  purports 
to  be,  an  original  and  highly  reasonable  theory  of  schizo- 
phrenia— ^while  others  insist  that  it  is  a  classical  exhibit  of  the 
disease  itself. 

The  present  judgment  of  the  author,  now  no  longer 
hospitalized,  is  that  his  paper,  as  it  stands,  is  probably  valid 
as  far  as  it  goes  but  needs  to  be  elaborated  and  extended  in 
certain  ways.  It  is  hoped  that  his  further  thinking  in  this 
connection  can  be  separately  published  at  a  later  date.  In 
the  meantime,  readers  will  be  free  to  form  their  own  opinions 
as  to  whether  the  production  presented  herewith  is  an  essen- 
tially valid,  albeit  perhaps  partial,  theory  of  schizophrenia — 
or  just  a  "phenomenological  perspective."  .  .  . 

Here  it  need  only  be  added  that  the  author  of  the  follow- 
ing essay  has  a  history  of  personal  waywardness  and  perver- 
sion (hence  the  anonymity)  which  could  easily  support  his 
original  thesis.  He  regards  the  present  document  as  largely 
an  expression  of  unconscious  processes,  rather  than  as  some- 
thing that  he  carefully  reasoned  out.  It  was  written,  he  says, 
"while  I  was  still  following  signals  and  colors;  some  of  it  was 
almost  automatic  writing."  The  author  gives  additional  infor- 
mation about  himself  at  the  end  of  the  paper. 

Before  proceeding  with  a  synopsis  of  the  paper  proper, 
it  will  be  well  to  present  the  following  information, 
ivhich  the  author  himself  gives  as  his  "qualifications"  for 
ivriting  such  a  paper.  He  lists  them  thus: 

Nearly  four  years  of  psychotherapy. 

Nearly  two  years  of  living  in  mental  hospitals. 

Observation  of  my  mother,  who  is  now  hospitalized  for 
the  fourth  time. 

Twelve  to  fifteen  years  of  self -analysis. 

A  B.A,  degree  and  one  year  of  graduate  work  in  psy- 
chology with  philosophy  as  a  minor. 

99th  percentile  on  the  Graduate  Record  Examination  in 
psychology. 

A  nearly  life-long  desire  to  contribute  to  knowledge,  espe- 
cially to  solve  the  problem  of  mental  illness. 

But  now,  to  return  to  the  essay  itself.  Near  the  outset 
the  author — whom  we  shall  know  as  Tim  Wilkins — 
jays: 


86  The  Crisis  in  Psychiatry  and  Religion 

I  propose  that  the  motive  force  of  schizophrenic  reactions 
is  fear,  just  as  fear  motivates,  according  to  Freud,  neurotic 
mechanisms — but  with  this  difference:  in  the  case  of  schizo-, 
phrenia,  the  chronic  fear  is  more  properly  called  terror,  ot 
concealed  panic,  being  of  the  greatest  intensity;  and  second! 
as  is  not  the  case  in  neurosis,  the  fear  is  conscious;  thirdJ* 
the  fear  itself  is  concealed  from  other  people,  the  motive  of 
the  concealment  being  fear.  In  neurosis  a  sexual  or  hostile 
drive,  pointing  to  the  future,  is  defended  against.  In  schizo- 
phrenia, by  my  view,  detection  by  others  of  a  guilty  deed, 
the  detection  pointing  to  the  past,  is  defended  against 
(pp.  2-3). 

One  of  the  things  that  gives  this  document  particular 
authenticity,  for  me,  is  the  way  in  which  the  author  here 
accepts,  without  question,  the  validity  of  Freud's  theory 
of  neurosis  but  then  goes  on  to  report  his  own  very 
different  inductions  about  schizophrenia.  By  1946  or  '47, 
when  Wilkins  had  his  last  contact  with  academic  psy- 
chology, the  Freudian  theory  of  neurosis  was  still  very 
much  in  vogue;  and,  writing  in  1956,  Wilkins  seems  to 
have  been  quite  unaware  how  widely  that  theory  was 
being  replaced  by  an  alternative  view  quite  similar  to  his 
own.  The  fact  that  Wilkins  apparently  did  not  know 
of  these  developments,  as  far  as  the  theory  of  neurosis 
was  concerned,  therefore  gives  his  formulations  concern- 
ing the  schizophrenic  psychoses  special  cogency  and 
independence — and  constitutes,  perhaps,  still  another 
indication  of  the  weakness  of  the  classical  Freudian  posi- 
tion. 

But  what,  more  specifically,  is  Wilkins'  theory  of 
schizophrenia?  As  much  as  possible  it  will  be  presented 
in  Wilkins'  own  words. 

My  hypothesis  [says  Wilkins]  may  be  called  the  Dick 
Tracy  theory  loosely  in  honor  of  the  familiar  fictional,] 
human  bloodhound  of  crime.  I 

Motivated  in  the  very  first  place  by  fear,  the  schizophrenic 
psychoses  originate  in  a  break  with  sincerity,  and  not  in  the 
classically  assumed  "break  with  reality."  The  patient's  social 
appetite  (an  instinctive  drive  in  primates,  I  believe),  includ- 
ing love  and  respect  for  persons  and  society,  is  consciously 
anticathected  or  forsaken  and  ultimately  repressed  with  the 
passage  of  time,  since  full  satisfaction  of  sociality  entails, 
more  or  less,  communicative  honesty,  faith,  and  intimacy. 
Also,  the  tension  set  up  in  interpersonal  intimacy  by  the 


[^uiLT,  Confession,  and  Expiation  87 

withholding  of  emotionally  important  (although  perhaps 
logically  irrelevant)  information  causes  unbearable  pain.  This 
repression  of  sociality  accounts  for  the  well-known  "indif- 
ference" of  schizophrenics.  But  if  safety  can  be  achieved  by 
means  of  "perjury"  alone  without  great  discomfort,  then 
no  further  defenses  are  adopted.  Perjury  is  here  defined  as 
avoiding  telling  the  whole  truth  and  nothing  but  the  truth. 
If,  for  many  possible  reasons,  perjury  is  not  an  adequate  and 
comfortable  guarantee  of  safety,  as  it  usually  is  not,  then 
"cutting"  of  social  contacts  is  progressively  pursued — all  in 
the  interest  of  safety  in  respect  to  avoiding  possible  punish- 
ment. Suppression  and  repression  of  the  social  appetite  or 
instinct  is  thus  central  to  schizophrenia.  I  believe  that  repres- 
sion of  sexual  and  hostile  drive  is  not  primary  in  schizo- 
phrenia, although  it  is  secondary,  as  will  be  explained  further 
on. 

Schizophrenia  is  the  cultivation  of  a  lie.  A  lie  is  "proved" 
to  be  the  "Truth."  The  real  truth  is  that  the  schizophrenic 
is  responsibly  guilty  for  some  crucial  misdeeds.  .  .  . 

In  my  view  a  large  amount  of  the  damage  to  the  schizo- 
phrenic's self-esteem  results  from  his  contemplation  of  his 
own  vicious  insincerity — which  damage  is  more  an  effect 
than  a  cause  of  his  disease.  His  unethical  defense  mechanisms 
cause  him  deep  shame  and  fear  of  loss  of  others'  esteem. 
In  addition,  the  primary  deeds — ^whose  exposure  and  punish- 
ment are  avoided  by  the  disease — are  shameful.  .  .  . 

More  broadly  speaking,  schizophrenia  shares  with  all  func- 
tional mental  illness  the  ultimate  danger  of  punishment 
meted  out  by  men,  demigods,  or  gods.  Common  punish- 
ments feared  are  the  being  deprived  of  love  of  kith  or  kin, 
loss  of  social  status,  financial  security,  etc.,  and  especially 
in  the  case  of  schizophrenia  the  more  violent  punishments 
such  as  being  abominated  by  kith  or  kin,  bodily  mutilation, 
imprisonment,  lynching,  execution. 

This  abandonment  of  social  ties  and  good  feeling,  in  the 
interest  of  personal  safety,  is  sometimes  starkly  simple,  as  in 
mutism,  but  is  usually  supplemented  by  the  development  of 
"phony"  social  behavior,  that  is  to  say,  designedly  cryptic  or 
misleading  expressions  of  interests,  sentiments,  opinions;  de- 
signedly unfriendly  "friendliness;"  asking  only  questions  to 
which  the  answers  are  already  known;  the  limitation  of 
conduct  to  carefully  self-criticized,  self-rehearsed  stratagems, 
etc.  The  patient  has  aggressed,  ultimately  in  self-defense,  by 
means  of  an  undeclared,  passive,  preventive  "war"  against 
his  fellow  men,  and  in  the  interest  of  preventing  defeat 
(positive  victory  is  soon  sensed  to  be  hopeless  of  attainment) 
most  of  his  knowledge  and  sentiments,  and  indeed  his  spon- 


88  The  Crisis  in  Psychiatry  and  Religion 

taneous  behavioral  tendencies,  have  been  classified  "top 
secret."  Whatever  words  he  actually  uses  are  employed,  thus, 
as  self-defensive  weapons.  My  Dick  Tracy  theory  offers  the 
explanation  that  high  reaction  time  results  from  "biding 
time"  in  the  service  of  caution.^  Time  is  needed  in  order  to 
creatively  choose  a  "phony"  (not  spontaneous,  not  honest, 
not  satisfying — except  with  respect  to  fear)  response  that 
will  maximally  conceal  the  patient's  mental  life  and  thus 
insure  safety. 

A  semi-instinctive  deceptive  stratagem  leads  schizophrenics, 
like  pursued  rabbits,  to  "zigzag,"  thus  baffling  the  pursuer's 
expectations.  Unpredictability  is  the  stock-in-trade  fetish  of 
schizophrenics.  The  proximate  goal  is  to  avoid  being  under- 
stood. The  ultimate  goal  is  to  avoid  punishment.  They  "non- 
want"  punishment  (pp.  227-228). 

My  hypothesis  diverges  from  orthodox  theory,  I  believe, 
in  insisting  that  a  large  part  of  the  schizophrenic's  fear  is  not 
a  symptom  and  is  not  repressed,  but  is  the  main  pathogenic 
force  and  is  accessible  to  consciousness  and  even  verbalization 
were  the  psychotic  to  violate  his  more  or  less  conscious  policy 
of  dissembling. 

There  are  understandable  reasons  why  others  may  not  have 
developed  this  view  sooner.  The  theorist  is  naturally  made 
to  appear  somewhat  hard-hearted  and  accusatory  [see  Chap- 
ter 21.  The  famihes  and  others  related  to  the  schizophrenic 
would  naturally  resent  the  implication  of  crime.  .  .  .  [And] 
it  is  easy  to  imagine  and  believe  that  physicians  and  psy- 
chologists would  not  enjoy  making  a  career  of  being  acces- 
sories after  the  fact  or  having  their  work  open  to  such  inter- 
pretation in  the  sociological  "climate"  afforded  by  present- 
day  attitudes.  Nor  would  professional  healers  in  general 
enjoy  arranging  for  prosecution  of  patients. 

In  other  words,  this  theory,  even  more  so  than  Freud's 
sexual  emphasis,  by  its  very  nature  would  stand  to  be  un- 
popular aU  around,  both  to  the  patients  and  the  healers  and 
the  social  group  which  surrounds  them  both.  In  fact,  were 
it  not  that  the  truth  promises  to  be  practically  invaluable 
in  the  long  run,  I  would  hope  that  my  theory  is  not  true. 

As  Freud  found  Shakespeare's  Hamlet  to  be  representative 
of  neurosis,  I  take  Shakespeare's  Lady  Macbeth  to  typify 
schizophrenic  psychoses.  The  motto  of  the  schizophrenic 
might  well  be,  "Out,  damned  spot!"  and  that  of  the  therapist 
working  with  schizophrenics,  "Find  the  crime!"  (p.  228). 

^The  author  is  here  alluding  to  a  study  of  reaction  time  in 
schizophrenics  with  which  he  was  familiar. 


Guilt,  Confession,  and  Expiation  89 

There  then  follow  sections  with  these  titles:  "Schizo- 
phrenia and  Criminality  Compared,"  "On  Crime  and 
Punishment,"  "The  Theory  and  Types  of  Schizophrenia,*' 
and  "Schizophrenia,  A  Social  Disease,"  in  which  further 
empirical  evidence  is  mobilized  in  support  of  the  theory 
and  implications  drawn  which  might  be  tested  by  further 
inquiry.  And,  toward  the  end  of  the  section  last  cited, 
ive  find  this  wistful  yet  trenchant  passage: 

My  theory  makes  schizophrenics  out,  in  a  sense,  to  be 
villains.  Yet  obviously  they  would  be  bungling  villains,  and 
the  very  botching  of  their  lives  strongly  suggests  forceful 
extenuating  circumstances,  since  without  tremendous  pressures 
people  seldom,  presumptively,  destroy  what  they  love  as 
much  as  all  people  love  themselves  originally. 

Irrelevantly,  it  is  pleasant  to  say  that  human  beings  are 
lent  dignity  (of  a  rather  evil  sort,  if  my  theory  is  true)  if  one 
credits  the  schizophrenics  of  the  human  race  with  being 
real  people  who  have  fallen  into  disease  by  having  failed  to 
make  the  right  decisions  at  the  right  time  in  regard  to 
problems  which  even  our  philosophers  and  theologians  have 
not  solved  in  the  quiet  of  their  studies  with  the  help  of 
the  written  words  of  many  other  minds — while  the  schizo- 
phrenics failed  under  enormous,  frantic  pressures,  as  is  typ- 
ically the  case  (p.  233). 

Then  there  is  a  section  entitled  "Thoughts  on  Ther- 
ipy"  and,  finally,  a  "Summary,"  which  reads,  in  part, 
IS  follows: 

So  what  is  a  schizophrenic?  In  brief,  he  is  a  terrified,  con- 
science-stricken   crook,    who    has    repressed    his    interest    in 
,   people,  unavowedly  insincere  and  uncooperative,   struggling 
I   against   unconscious   sexual   perversion.   He   is   of   no   mean 
j   Thespian  ability.   And  his  favorite   Commandment  is   that 
which  one  nowadays   facetiously   calls   the   Eleventh   Com- 
mandment, "Thou  shalt  not  get  caught." 

Attempts  to  expose  him  may  only  drive  him  further 
"underground."  But  a  knowledge  of  his  true  nature  will 
surely  lead,  someday,  to  somebody's  discovering  a  sure,  quick, 
effective  and  enduring  cure  (p.  236). 

As  already  indicated,  there  are  those  who  insist  that 
he  sense  of  guilt  and  wrong-doing  which  the  author  of 
his  paper  stresses  is  itself  pathological;  and  some  would 
ven  hold  that  the  misdeeds  to  which  the  schizophrenic 


90  The  Crisis  in  Psychiatry  and  Religion 

person  points,  if  real,  are  an  early  expression  of  disease, 
rather  than  a  cause  thereof.  But  this  position  has  the 
logical  defect  of  making  all  misconduct  interpretable  in 
this  way  and  thus  obliterates  the  whole  concept  of  per- 
sonal and  moral  responsibility.  Moreover,  there  are  now 
psychiatrists,  including  some  very  eminent  ones,  whO; 
feel  that  this  view  is  unsound  even  when  limited  to  the; 
most  obviously  *'sick"  individuals  and  that  an  entirely 
different  orientation  is  needed.  For  example,  after  the, 
publication  of  Tim  Wilkins'  paper,  Dr.  Karl  Menningei 
(1958)  wrote  as  follows: 

I  very  much  liked  the  article  on  schizophrenia  ...  in  the 
September  issue  of  THE  JOURNAL  OF  ABNORMAI 
AND  SOCIAL  PSYCHOLOGY.  I  wish  you  would  tell  [the 
author]  that  I  think  it  is  fine  and  that  it  would  be  even 
little  better,  in  my  opinion,  if  he  would  not  try  to  distinguis 
between  schizophrenia  and  other  groups  of  symptoms.  Essen 
tially  all  mental  illness  must  be  a  reaction  to  some  kind  o 
feeling  of  rupture  with  the  social  environment,  and  of  course 
it  is  typical  of  many  patients  to  identify  this  with  their  owi 
aggressive  intent  or  even  aggressive  acts  for  which,  as  [th< 
author]  says,  they  feel  guilty  and  about  which  they  ar« 
defensive  and  evasive  and  insincere. 

Or  consider  this  observation,  reported  by  Hock 
Polatin  (1949)  in  connection  with  their  study  of  a  larg 
group  of  borderline — or  what  they  prefer  to  call  "pseudo 
neurotic" — schizophrenics : 

In  all  the  writers'  cases,  they  observed  that  the  patien 
usually  told  of  a  great  many  sexual  preoccupations  showin 
autoerotic,  oral,  anal,  homosexual  and  heterosexual  tendencie: 
and  ideas  which  sometimes  resembled  a  textbook  of  ps) 
chopathia  sexualis.  These  polymorphus  perverse  manifest 
tions,  this  chaotic  organization  of  the  patient's  sexuality,  tb 
writers  feel,  is  rather  characteristic  of  these  schizophreni 
cases.  Marked  sadistic  or  sado-masochistic  behavior  is  ofte 
linked  with  this  sexual  material.  This  is  especially  true  i 
patients  who  rather  overtly  and  without  restraint,  expre: 
incestuous  ideas.  Many  of  these  patients,  especially  und( 
sodium  amytal,  verbalize  these  ideas  freely,  or  express  thei 
freely  in  drawings  (p.  253). 

Recently  a  state  hospital  conducted  an  all-day  institui 
for  clergymen  for  which  the  head  of  the  Social  Servic 
Department  had  prepared  a  case  history  of  a  33-year-o] 


Guilt,  Confession,  and  Expiation  91 

woman  who,  it  was  felt,  rather  well  typified  entering 
patients.  For  a  period  of  two  years,  this  woman  had  been 
having  an  affair  with  her  brother-in-law;  she  had  on  one 
occasion  assaulted  her  husband  with  a  butcher  knife; 
and  on  another  occasion  had  thrown  a  small  child  over 
a  backyard  fence.  Finally  she  became  suicidal  and  had 
to  be  hospitalized. 

And  so  might  one  continue,  indefinitely,  to  mobilize 
bvidence  that  sin  and  emotional  sickness  are  no  strangers 
to  one  another  and  that  it  is  only  by  flagrant  disregard 
oi  the  clinical  facts  that  one  can  imagine  that  neurotic 
and  functionally  psychotic  individuals  have  been  too 
:horoughly  socialized  and  are  the  victims  of  an  unduly 
evere,  oppressive  morality.  Therefore,  although  it  is 
Realized  that  the  evidence  cited  will  probably  not  be 
ufficient  to  convince  anyone  holding  a  strongly  contrary 
^^iew,  it  will  be  accepted  here  as  typical  of  a  much  larger 
body  of  facts  which  justify  further  consideration  of  the 
dew  that  mental  illness  is  a  social  and  moral  illness  and, 
in  the  final  analysis,  capable  of  remediation  only  along 
social  and  moral  lines. 


[I.   GUILT,   REMORSE,   AND   CONFESSION 

If  it  be  true  that  emotionally  ill  persons  are  typically 
guilty  persons,  i.e.,  persons  with  real  guilt  rather  than 
mere  guilt  feelings^  the  question  very  naturally  arises  as 
:o  what  can  be  done  to  alleviate  such  a  state  of  affairs. 
Everyone  apparently  has  an  intuitive  compulsion  to 
idmit,  or  confess,  his  guilt  to  others;  but  this  is  a  very 
Dainful  act  and  is  likely  to  occur  only  under  great 
irgency.  A  dramatic  itistance  of  confession,  and  the 
conflict  it  involves,  is  given  in  the  following  paragraphs. 
rhey  are  taken  from  Standal  &  Corsini's  (1959)  book, 

ritical  Incidents  in  Psychotherapy.  I  may  say  that 
Jie  counselor  here  reporting  is  not  identified,  and  the 
client  is  known  only  as  ''Jo^'^-"  The  counselor  begins  by 
^ving  the  background  facts: 

Joan  is  a  nineteen  year  old  college  freshman.  She  was  first 
seen  while  she  was  attending  Junior  College.  The  school 
psychologist  had  diagnosed  her  as  a  Paranoid  Schizophrenic 
on  the  basis  of  a  Rorschach  test  and  had  referred  her  for 


92  The  Crisis  in  Psychiatry  and  Religion 

psychotherapy  to  a  counsehng  center  which  uses  a  chent 
centered  approach. 

The  therapist  to  whom  Joan  was  assigned  (the  preseni 
author),  noted  no  psychotic  symptoms  until  the  sixth  inter 
view  when  she  had  an  hallucination  and  expressed  some 
bizarre  ideas.  After  this  interview,  the  therapist  asked  for  £ 
consultation  with  a  psychiatrist  which  was  followed  by  a  joini 
interview  with  the  patient  and  continuing  consultation  durin§ 
the  course  of  treatment. 

The  critical  incident  described  occurred  in  the  fourteentl: 
interview.  Joan  had  been  seen  initially  for  eight  interviews 
followed  by  a  month  and  a  half  of  summer  vacation,  anc 
then  five  more  interviews  before  she  left  town  to  go  to  i 
state  university.  She  had  been  at  the  university  for  one  weel 
when  she  called  the  therapist  and  said  she  wanted  to  com( 
back  during  the  weekend  for  an  appointment.  One  was  sel 
for  five  o'clock  on  Saturday. 

Joan  arrived  almost  on  time,  breaking  a  precedent  oj 
coming  consistently  twenty  to  thirty  minutes  late.  She  saic 
she  was  quite  disturbed  and  had  tried  to  reach  me  twic{ 
during  the  afternoon  but  I  wasn't  there. 

I  asked  her  how  much  time  she  would  like.  (Our  previou: 
interviews  had  all  been  for  whatever  was  left  of  fifty  minute: 
after  her  late  arrival.)  I  opened  the  possibility  of  a  longei 
interview  in  reaction  to  her  apparent  degree  of  disturbance 
and  the  inaccessibility  of  the  clinic  to  her  new  residence  aij 
the  university.  She  asked,  "What  do  you  mean?"  I  said,  "Ij 
wonder  if  you  would  like  more  than  an  hour  today?"  Sh(i 
said,  "Yeah,  I  would."  I  asked  her,  "Well,  how  much  tim^i 
would  you  like?"  She  did  not  try  to  answer  the  questioi! 
so  I  said,  "Suppose  we  continue  until  we  both  get  hungrj 
and  it's  time  to  go  home  for  supper." 

She  began  then  talking  about  her  experience  at  the  univer 
sity.  She  described  the  loneliness  that  she  felt — the  isolation 
Nobody  really  loved  her.  She  just  felt  all  alone  in  the  world 
Life  was  so  depressing  that  she  couldn't  work  up  interest  ii 
anything.  She  didn't  have  the  push  to  do  anything.  If  sh( 
had  the  push,  she  thinks  she  would  commit  suicide.  If  th( 
future  were  merely  an  extension  of  the  present,  then  r 
would  not  be  worth  living  for.  She  was  expressing  a  deej 
despair  when  she  began  to  pull  herself  together  again.  Theo 
would  be  some  hope  if  she  could  change  herself.  She  begai 
to  feel  that  maybe  she  did  have  the  possibility  for  changing 

During  a  pause  in  this  working  through  of  feeling,  '. 
wondered  about  the  time.  Taking  out  my  watch,  I  discov 
fxed  that  it  was  six-thirty  and  that  we  had  been  togethe. 
for  an  hour  and  a  half.  I  put  my  watch  on  the  desk  anc 
asked  her,  "How  much  more  time  do  you  want?"  She  didn' 


!JuiLT,  Confession,  and  Expiation  93 

answer.  The  watch  sounded  loud  ticking  away,  so  I  put  it 
back  in  my  pocket.  We  went  on  until  about  seven,  when  I 
,  began  to  feel  weak  and  wasn't  following  her  very  well.  I 
said  this  to  her  and  she  looked  up  at  me  like  a  scared  rabbit. 
She  smiled  in  a  forced  way  and  began  putting  on  her  coat 
j  as  if  preparing  to  leave.  I  said,  "You  looked  frightened  when 
I  I  suggested  it  might  be  time  to  stop."  She  nodded.  I  said, 
!  "Almost  as  if  you  thought  I  was  rejecting  you  then."  She 
said,  "Yes,  that's  what  it  looked  like  to  me."  Then  she  pulled 
i  her  coat  together  over  her  chest.  Her  hands  clenched  strongly 
on  the  coat  and  she  started  to  stare  at  the  wall.  Her  eyes 
got  red  but  no  tears  came.  She  began  to  tremble.  I  did  not 
understand  what  was  happening  and  said,  "It  seems  as  if 
the  feelings  you  have  now  are  making  you  afraid."  She  just 
nodded  without  looking  at  me.  Her  trembling  and  staring 
went  on  for  about  eight  minutes.  Then  she  stood  up  in 
front  of  me.  I  asked  her  if  she  wanted  to  go  home.  She 
looked  at  me,  smiled  again  in  a  mechanical  fashion  and 
shook  her  head  "no."  Then  she  began  wringing  her  hands, 
staring  at  the  wall  and  shaking  all  over.  From  time  to  time 
her  body  would  lean  toward  me  and  then  lean  away.  My 
heart  was  beating  like  a  trip  hammer.  I  didn't  understand 
what  was  happening  to  her.  I  was  afraid  that  she  might  be 
going  into  a  psychotic  break.  After  about  ten  minutes  of 
throbbing  silence,  I  said,  "It's  hard  for  me  to  understand 
what  you  are  feeling."  Then  she  said  that  she  was  looking 
at  the  lambs  on  the  wall,  the  faces  of  the  lambs.  (There 
was  a  flower  print  on  the  wall.)  "They  have  two  eyes.  One 
is  a  mean  eye  and  the  other  is  a  kind  eye.  I  see  the  faces  of 
my  mother  and  my  grandmother.  They  are  telling  me  to 
control  myself  and  I  hate  them"  (pp.  38-40). 

When  I  have  previously  presented  this  material  orally, 
have  usually  stopped  at  this  point  and  asked  for  the 
ipressions  of  others  as  to  what,  precisely,  was  going  on 
2re.  Even  a  group  of  laymen  will  come  through  with 
fairly  accurate  appraisal.  They  will  see,  first  of  all,  the 
^inly  veiled  seductiveness  of  the  client:  her  avowed 
neliness  and  vagueness  about  when  she  needs  to  leave, 
^hen  the  therapist  tries  to  force  the  latter  issue,  Joan 
oked  frightened,  hurt — and  he  interprets  this,  probably 
lite  correctly,  as  indicating  a  feeling  on  Joan's  part  of 
?ing  "rejected."  Clearly  the  counselor  had  rejected  Joan 
regards  any  sexual  advances  that  she  may  have  been 
aking  to  him.  With  the  situation  thus  clarified  and 
estructured,"  things  began  to  happen.  Almost  imme- 


94  The  Crisis  in  Psychiatry  and  Religion 

diately,  "she  pulled  her  coat  together  over  her  chest.  He 
hands  clenched  strongly  on  the  coat  and  she  started  t( 
stare  at  the  wall."  Presently  she  stood  up  in  front  o 
the  therapist  and  physically  acted-out  her  conflict  b' 
alternatively  leaning  toward  and  away  from  him.  Thei 
she  hallucinated.  Eyes  are  a  proverbial  symbol  of  author 
ity  and  conscience,  and  Joan  reflects  her  ambivaleno 
toward  them  by  seeing  one  of  the  eyes  of  each  lamb* 
face  as  good,  one  bad.  Then  Joan  sees  the  faces  of  he 
mother  and  grandmother — faces,  so  to  say,  which  wer 
''behind"  conscience.  *They  are  telling  me  to  contro 
myself  and  I  hate  them."  The  fact  that  moral  authoriti 
had  here  been  internalized  but  not  assimilated  is  thuj 
apparent;  and  it  is  noteworthy  that  such  authority  ij 
depicted  as  exclusively  female — there  is  no  fatherly  fac 
here. 

Having  thus  paused  the  better  to  grasp  this  rapid 
moving   and   dramatic    scene,    we   now   return   to   th 
counselor's  narrative. 

I  told  her  I  was  puzzled.  Then  I  said,  "I  wonder  if  yo 
are  saying — in  part  you  like  yourself,  in  part  you  don't  li 
yourself."  She  said,  "No.  It's  other  people's  reactions  to  mf 
They  partly  like  me  and  partly  don't  like  me."  She  said  thz 
one  of  the  eyes  was  covered  over  with  wool.  I  said, 
wonder  if  you  are  saying  that  if  people  really  knew  you- 
could  see  the  real  you — that  they  would  not  like  you."  Sh 
said,  "Yes." ' 

In  between  these  times  when  we  talked  together,  she  WJ 
still  standing,  trembling,  wringing  her  hands  and  staring 
the  wall.  Then  she  began  to  tell  me,  in  a  very  circuitoi 
way,  about  her  relationship  with  her  father.  She  started  oi 
by  saying  that  when  she  was  thirteen  years  old,  she  ha 
seen  the  divorce  papers  of  her  parents.  In  those  papers 
said  that  her  father  had  not  wanted  her  before  she  was  bon 
Then  she  went  on  to  describe  her  father's  attitude  towai 
her  and  after  many  hints  told  me  about  having  had  incestuoi 
relations  with  her  father.  She  described  this  as  the  experiem 
which  has  made  her  dirty,  no  good,  horrible. 

She  had  been  standing  and  shaking  for  half  an  hour  bi 
having  brought  out  this  report  of  incest,  she  sat  down  an 

^No  explicit  reference  is  made  here,  by  either  the  client  i 
the  counselor,  to  the  common  expression,  "pulling  the  wool 
over  another's  eyes  as  a  metaphor  for  deception;  but  it  seen 
to  have  been  mutually  understood  and  accepted. 


^uiLT,  Confession,  and  Expiation  95 

relaxed.  She  looked  at  me  while  she  talked,  really  seeing  me 
for  the  first  time  since  she  had  stood  up  and  described  how 
this  experience  had  affected  every  part  of  her  life.  She  had 
never  told  this  to  anyone  before.  She  felt  she  could  not  tell 
her  mother  or  her  grandmother.  Even  with  her  father,  she 
pretends  that  it  had  never  happened  and  he  never  mentions 
it.  She  no  longer  has  sex  relations  with  him  but  when  she 
visits  him  (her  parents  are  separated)  she  takes  along  a 
friend  to  protect  herself. 

When  it  was  about  eight  o'clock,  I  found  I  was  again 
beginning  to  get  hungry.  I  said,  "Well,  I'm  beginning  to 
get  weak  again."  She  said,  "You  know,  I've  got  a  headache 
and  I'm  hungry.  I'm  just  all  worn  out  and  I  really  haven't 
much  more  to  say  today.  But  I  couldn't  tell  you.  I  couldn't 
suggest  that  we  stop."  It  developed  that  she  was  afraid  that 
that  would  be  rejecting  me. 

Again  it  takes  no  special  intuitiveness  to  see  what  had 
ccurred  here.  Joan  had  come  to  the  interview  conflicted 
etween  the  possibility  of  admitting  the  incestuous  rela- 
onship  with  her  father  and  of  replicating  it,  with  the 
Dunselor.  What  she  would  have  actually  done  had  the 
Dunselor  gone  along  with  the  first  possibility  we  can 
nly  conjecture — first  of  all  because  this  is  not  what 
appened  and  secondly  because,  if  it  had,  there  would 
ave  been  no  record  of  the  case,  or  at  least  not  one 
3luntarily  supplied  by  the  counselor!  But  the  mystery 

still  not  completely  solved.  Why  does  Joan  have  to 
ngle  out  this  particular  man?  Surely  there  were  both 
lore  appropriate  and  more  accessible  sex  objects  in  even 
er  impoverished  social  environment  than  this  obviously 
:der,  presumably  married,  and  professionally  responsible 
[dividual.  Actually,  the  very  paradox  provides  the  key. 
)an  arranged  this  Saturday-afternoon  tryst  with  the 
)unselor,  not  because  she  was  sexually  starved,  but 
2cause  she  was  morally  oppressed;  and  if  she  could 
ave  seduced  this  father  figure,  as  she  had  her  original, 
.ological  father,  she  would  have  won  at  least  a  transitory, 
lOugh  ultimately  bogus,  moral  victory  of  considerable 
iagnitude.3 

'Only  those  without  experience  in  the  psychotherapeutic 
:uation  will  regard  the  sexual  interplay  here  implied  as  either 
lusual  or  misperceived.  The  only  question  is  one  of  interpreta- 
)n,  "dynamics,"  meaning. 


96  The  Crisis  in  Psychiatry  and  Religiq 

Certainly  it  was  no  accident  that  her  father's  face  wj 
not  among  those  staring  out  at  Joan  from  the  wall- 
and  from  the  past.  As  a  father  he  was  dead — and  Joa 
had  helped  kill  him.  Having  with  Joan's  cooperatio 
irreparably  disgraced  and  disqualified  himself  for  tk 
role,  he  could  no  longer  *'face"  her.  But  the  mothti 
and  the  grandmother  had  not  been  so  effectively  dispose 
of;  and  although  Joan  hated  them,  they  gave  her  no  res' 
So  on  this  fateful  Saturday  afternoon,  Joan  came  nc 
awooing  in  any  usual  sense  of  that  term,  but  rather  wit 
confused  and  mixed  intentions  of  confession  and  "mu: 
der."  But  her  possible  victim  was  this  time  immune  t 
her  devices.  When  confronted  by  a  hardly  mistakabl 
sexual  invitation,  all  he  did  was  to  talk  about  how  wea 
and  hungry  he  was  feeling!  And  he  was  right  in  perceiv 
ing  that  Joan,  or  at  least  a  part  of  her,  did  "feel  rejected. 
This  time  Joan  had  met  her  match;  this  father  wa 
incorruptible.  And  she  had  the  courage  and  characte 
to  make  the  most  of  it:  to  him  she  then  confessed.  Sh 
had  "tried"  him,  and  he  had  qualified  for  this  differen 
role. 

There  is  only  a  little  more  to  the  counselor's  account 
He  concludes  by  asking  a  series  of  questions: 

What  part  did  the  handling  of  time  play  in  this  interview 
Did  the  indecisiveness  of  the  therapist  lead  to  a  seductiv 
interplay  which  aroused  transference  reactions,  helping  t 
precipitate  the  temporary  psychotic  break?  If  so,  how  shouL 
this  be  evaluated  therapeutically?  Would  a  firm  initia 
definition  of  limits  by  the  therapist  have  cut  off  the  possi 
bility  of  the  intensive  catharsis  which  occurred  during  th 
last  hour?  j 

The  therapist  interpreted  the  client's  hallucinatory  thought! 
in  terms  of  her  attitudes  toward  her  self  and  her  relationship! 
with  other  people.  What  would  have  been  the  effect  oi 
merely  reflecting  the  ideas  which  she  was  verbalizing?  Whai 
would  have  been  the  effect  of  interpreting  her  behavior  iij 
terms  of  a  transference  neurosis?  I 

Although  the  counselor  seems  to  have  had  a  gooc! 
intuitive  grasp  of  the  situation  and  handled  it  well,  ht: 
was  so  preoccupied,  apparently,  with  questions  of  "techi 
nique"  that  he  was  consciously  blinded  to  the  deepei! 
significance  of  what  really  transpired.  After  Joan  said,' 


Guilt,  Confession,  and  Expiation  97 

"But  I  couldn't  tell  you  [and]  I  couldn't  suggest  that 
we  stop/'  his  comment  is:  "It  developed  that  she  was 
afraid  that  that  would  be  rejecting  me."  Surely  something 
far  more  profound  was  going  on  here  than  any  such 
terminology  would  imply;  and  it  is  with  precisely  this 
Something  More  that  we  are  here  mainly  concerned. 

[II.   IS   CONFESSION   ENOUGH? 
THE   PROBLEM   OF   EXPIATION 

Despite  the  Biblical  exhortation  that  an  honest  con- 
fession is  good  for  the  soul,  there  is  reason  to  doubt  that 
its  benefit  is  unconditional  and  necessarily  enduring;  and 
one  wonders  how  much,  in  the  long  run,  was  really 
accomplished  in  the  episode  we  have  just  reviewed. 
Immediately  thereafter  Joan,  to  be  sure,  felt  vastly  re- 
lieved; but  was  she  ''cured"?  What  guarantee  was  there, 
really,  that  her  guilt  would  be  generally  assuaged — or, 
indeed,  that  she  would  not  again  resort  to  the  very 
behavior  which  had  already  caused  her  so  much  inner 
discomfort?  The  author  of  the  Dick  Tracy  theory  puts 
the  problem  well  by  asking  in  a  part  of  his  paper  not 
previously  quoted:  What  good  does  it  do  to  confess  your 
past  errors  to  someone  who  is  going  to  be  as  secretive 
about  them  as  you  have  been?  This,  he  goes  on  to  say,  is 
not  the  way  for  a  person  to  achieve  social  redefinition 
of  personality  and  true  redemption.  Just  as  the  offense 
has  been  against  society — that  is,  against  the  laws  of  man 
and  God — so,  one  might  argue,  the  confession  and 
Forgiveness  (''acceptance")  must  be  as  broad  as  the  sin 
itself. 

Another  one  of  the  "critical  incidents"  collected  by 
Standal  and  Corsini  bears  quite  directly  upon  this  ques- 
l:ion.  Here  a  married  woman  consults  a  psychiatrist  with 
pomplaints  of  depression  and  obsessive  thoughts  that  she 
alight  injure  her  young  daughter.  After  desultory  talk 
(during  the  course  of  several  interviews)  had  revealed 
[lothing  but  an  exemplary  life,  the  psychiatrist  confronted 
che  patient,  almost  roughly,  with  the  logical  incongruity 
oetween  her  symptoms  and  what  she  had  told  him  about 
lerself.  With  great  effort,  there  was  then  admission  of  a 
;urprising  and  particularly  degrading  perversion;  but  there 


98  The  Crisis  in  Psychiatry  and  Religion 

was  no  dramatic  therapeutic  gain.  In  fact,  the  report  ends 
with  a  comment  by  the  psychiatrist  to  the  effect  that  the 
patient  is  ''still  in  treatment." 

One  is  therefore  prompted  to  wonder  what  would  hap- 
pen, in  situations  of  this  kind,  if  the  confession  took  a 
more  "public"  form.  Fortunately  we  have  something  of 
an  answer  in  a  case  which  has  been  briefly  reported  by 
Dr.  Anton  Boisen  (1958).  He  says: 

The  patient  in  question  was  a  man  of  thirty-eight  years 
who  was  brought  to  the  hospital  in  a  severely  agitated  con- 
dition. He  thought  he  had  committed  the  unpardonable  sin 
and  that  something  was  going  to  happen  to  his  wife  and 
children.  He  would  not,  therefore,  let  them  out  of  his  sight. 
He  thought  a  world  war  was  impending  and  when  asked 
what  part  he  was  to  have  in  this  war,  he  replied,  "A  little 
child  shall  lead  them."  Obviously,  he  was  the  little  child. 

The  record  of  his  life  was  that  of  a  well-meaning,  friendly, 
likeable  person  who  before  his  marriage,  and  even  afterward, 
had  been  sexually  promiscuous.  What  troubled  him  most  was 
an  affair  with  a  woman  some  ten  years  older  than  himself, 
clearly  a  mother  substitute.  There  had  been  two  abortions, 
for  which  he  was  responsible.  She  had  died  of  carcinoma. 
He  blamed  himself  for  her  death  and  the  disturbance  began; 
shortly  thereafter. 

The  first  symptom  was  heavy  drinking.  This  continued! 
until  he  lost  his  job.  Following  this,  he  suffered  a  depression 
and  stopped  drinking.  Then  he  developed  the  idea  that  thej 
Odd  Fellows  were  out  to  get  him  because  he  had  violated] 
the  oath  he  took  when  he  joined  them.  For  several  monthsi 
he  was  obsessed  with  ideas  of  persecution.  He  reached 
the  point  where  he  went  to  the  police  with  a  request  for  a! 
permit  to  carry  a  gun  in  order  to  protect  himself  from  his| 
enemies.  He  then  became  finally  so  disturbed  that  he  con-j 
fessed  to  his  wife,  telling  her  of  his  sexual  transgressions.      ! 

This  confession  she  took  in  good  spirit,  but  in  spite  of  thai] 
fact  he  became  more  and  more  agitated.  The  idea  came 
that  something  was  going  to  happen  to  her  and  that  he  had 
to  carry  the  weight  of  the  world  on  his  small  shoulders 
Commitment  then  became  necessary.  In  the  hospital  he 
showed  intense  anxiety.  He  was  sure  of  only  one  thing,  that 
things  were  not  what  they  seemed.  He  was  also  deepl} 
aroused  religiously.  It  is  not  necessary  for  our  purpose  tc 
recount  his  subsequent  history  beyond  reporting  that  within 
a  couple  of  months  he  made  an  excellent  recovery  and  now.; 
after  nearly  thirty  years,  there  has  been  no  further  trouble* 

i 


Guilt,  Confession,  and  Expiation  99 

He  is  at  present  a  successful  contractor  and  his  family  is 
prosperous  and  happy. 

After  noting  that  this  man*s  guilt  was  real  and  grievous, 
Boisen  then  asks: 

Why  now  the  increased  agitation  following  the  confession 
to  his  wife?  Such  a  question  is  in  order.  The  answer  is  clear. 
The  emotional  disturbance  was  not  the  result  but  the  pre- 
condition of  the  confession.  In  his  normal  state  of  mind 
confession  would  have  been  impossible.  But  the  profound 
emotion  forced  the  confession,  just  as  nature's  heahng  power 
produces  a  boil  or  an  abscess  and  then  lets  the  poison  matter 
out.  In  this  case,  as  in  others  of  the  type,  the  disturbance 
brought  about  a  certain  degree  of  socialization.  It  got  rid 
of  pretense  and  hypocrisy  and  put  the  sufferer  in  position 
to  be  accepted  for  what  he  really  was.  And  if  it  took  some 
time  for  this  powerful  emotion  to  subside,  that  is  hardly  to 
be  wondered  at"  (pp.  5-6,  italics  added). 

All  this  is  eminently  reasonable,  but  does  it  not  over- 
look another  possibility?  Voluntary  confession  of  a  legal 
crime  may  soften  the  ensuing  punishment,  but  it  does 
not  abrogate  it.  So,  may  we  not  assume  that  confession 
of  an  immorality  likewise  does  not  end  the  matter?  In 
Dr.  Boisen's  case  I  conjecture  that  the  period  of  hos- 
pitalization was  dynamically  necessitated  by  the  confes- 
sion. This  man,  probably  with  human  beings  generally 
in  like  situations,  felt  that  accounts  could  not  be  righted 
until  he  had,  as  we  often  say,  ''taken  his  medicine"  and 
paid  for  his  past  misdeeds.  Can  it  be  that  we  do  not 
properly  perceive  this  function  of  the  mental  hospital  and 
I  hospitalization? 

i     Does  mere  confession  of  a  legal  crime  absolve  one  from 
'all  further  responsibility  or  punishment?  Suppose  that 
jlO   years   ago   I   committed   a   murder   and   was   never 
[caught  or  even  suspected.  But  as  time  passes,  my  own 
knowledge  of  the  act  becomes   increasingly  oppressive 
and  I  finally  go  to  the  local  police  and  say:  "You  remem- 
ber a  man  by  the  name  of  Joe  Smith  who  was  mys- 
iteriously  murdered  a  few  years  ago.  Well,  I  thought  you 
might  just  like  to  know  that  I  killed  him."  What  would 
then  happen?  Would  the  police  say,  "How  very  inter- 
esting! We  often  wondered  what  happened  to  that  fel- 


100  The  Crisis  in  Psychiatry  and  Religion 

low.  Drop  in  again  sometime."  Obviously  not!  I  would 
be  taken  into  custody,  would  have  to  stand  trial,  and,  if 
formally  convicted,  would  be  sentenced  to  what  was 
deemed  appropriate  punishment. 

Now  is  the  moral  law  less  demanding  than  the  civil 
and  criminal  codes?  Does  conscience  have  less  rectitude 
than  a  court?  Unless  we  can  answer  this  question  affirma- 
tively, it  follows  that  in  the  moral  realm,  no  less  than  in 
law,  confession  is  not  enough  and  must  be  accompanied 
by  restitution.  This  possibility  has  been  generally  neg- 
lected in  our  time  and  may  account  for  widespread  con- 
fusion and  misdirected  therapeutic  and  redemptive  effort. 
Psychologists  and  psychiatrists  have  stressed  the  impor- 
tance of  "insight"  rather  than  personal  guilt  and  repent- 
ence;  and  even  the  church  has  preached  what  Dietrich 
Bonhoeffer  (1948)  has  called  the  doctrine  of  "cheap 
grace,"  which  he  holds  is  no  grace  at  all  [see  Chapter  11]. 

So  can  it  be  that,  lacking  formal  (institutional)  recog- 
nition of  the  need  for  atonement  following  sin,  modern 
men  and  women  commonly  make  use,  unconsciously,  of 
the  stigma,  disgrace,  and  suffering  connected  with  being 
"crazy"  and  hospitalized?  Dr.  Boisen  (1936)  has  referred 
to  the  insane  as  the  self-condemned;  and  to  this  we  might 
add  that  they  are  also  the  self -punished.  Depression  is 
manifestly  a  form  of  self-inflicted  suffering;  and  it  has 
often  been  suspected  that  the  reason  why  electro-convul- 
sive shock  "treatment"  may  speed  the  recovery  of  de- 
pressed persons  is  that  it  aids  the  work  of  expiation.  Cer- 
tainly it  is  not  uninstructive  that  even  untreated  depres- 
sion tends  to  "run  its  course,"  that  the  prospect  of 
recovery  from  any  one  "attack"  is  always  good  but  that 
recurrences  are  statistically  likely  (hence  the  diagnosis 
of  "cyclothymia").  Therefore,  a  depression  looks  very 
much  like  an  act  of  "serving  time,"  comparable  to  what 
happens  in  those  other  places  of  penance  (or  peniten- 
tiaries) where  legally  convicted  offenders  are  sent.  In 
both  instances,  when  one  has  "paid  his  debt  to  society," 
he  is  again  free  (of  prison  in  the  one  case,  of  depression 
in  the  other);  and  the  question  of  whether  an  individual 
will  have  one  or  more  later  depressions  or  will  be  "cured" 
depends  (in  much  the  same  way  as  does  the  reformatory 
action  of  prison)  upon  whether  he  has  really  "connected" 
crime  and  punishment. 


A 


Guilt,  Confession,  and  Expiation  101 

But  what  of  schizophrenia?  Here  the  likehhood  of 
"spontaneous  remission"  (getting  "out,"  being  "free")  is 
not  nearly  so  great;  and  many  students  of  the  problem 
have  been  led  to  suspect  a  deeper  malignancy  here — 
tainted  heredity,  disordered  metabolism,  or  the  like.  Can 
it  be  that  Tim  Wilkins  is  right,  that  schizophrenia  is  no 
less  a  moral  disorder  than  is  depression  but  that  in  the 
one  case  the  individual  is  still  running,  hiding,  denying, 
whereas  in  the  other  the  individual  at  least  unconsciously 
admits  his  wrong  and  accepts  the  justice  of  suffering? 
In  the  Boisen  case — which  had  such  a  favorable  outcome 
— we  have  an  individual  who  showed  an  admixture  of 
depressive  and  schizoid  reactions;  and  apparently  much 
depends,  with  respect  to  recovery,  upon  whether  one  or 
the  other  gains  the  ascendancy.  As  Dr.  Boisen  has  else- 
where (1936)  pointed  out,  those  persons  who  react  to 
personality  crisis  by  becoming  resentful  and  bitter  and 
who  blame  others  rather  than  themselves  are  well  on  the 
way  to  a  permanently  paranoid  adjustment,  with  a  very 
poor  prognosis.  But  when  the  individual  can  blame  him- 
self and  see  his  predicament  as  one  for  which  he  is  largely 
responsible  and  which  he  can  do  something  toward 
changing,  the  prospects  of  recovery — and  personal  trans- 
formation— are  much  brighter  [see  Chapter  13]. 

Toward  which  of  these  courses  is  would-be  therapeutic 
endeavor  usually  directed?  How  often  we  have  tried  to 
get  the  neurotic  or  psychotic  (sinful?)  individual  to  see 
his  difficulties  as  stemming  from  sources  outside  his  own 
ego  or  self — from  a  too  strict  superego,  from  unreason- 
able, tyrannical  parents,  or  from  a  "sick  society"!  And 
how  often  we  have  perhaps  thus  unwittingly  pushed  the 
individual  in  the  very  direction  that  leads  to  destruction 
rather  than  salvation! 

At  mid-twentieth  century,  perhaps  secular  psycho- 
therapy has  already  rediscovered  one  ancient  religious 
truth  and  is  on  the  verge  of  discovering  another.  Perhaps 
one  of  the  reasons  why  classical  psychoanalysis,  with  its 
cardinal  emphasis  upon  "free  association,"  so  often  makes 
a  painful  and  productive  start  and  then  tails  off  into 
years  of  dull  and  unprofitable  talk  is  that  it  does  not  help 
the  analysand  move  from  free  association  (confession) 
on  to  atonement,  except  to  the  extent  that  the  financial 
sacrifice  which  analysis  usually  entails  provides  it  in  at 


102  The  Crisis  in  Psychiatry  and  Religion 

least  temporary  or  ''symptomatic"  form.  Perhaps  the 
next  half  century  will  be  well  spent  if  we  do  nothing 
more  than  learn  how,  once  again,  to  make  use  of  mean- 
ingful and  effective  restitution  as  a  regular  and  expected 
concomitant  of  confession  (cf.  the  book  of  Leviticus  in 
the  Old  Testament).  Perhaps  there  are  both  individually 
and  socially  more  constructive  forms  of  self-punishment 
and  atonement  than  incarceration  in  a  mental  hospital.^ 

*  Since  the  above  was  written,  the  author  has  learned  of  a 
book  now  in  preparation,  under  the  editorship  of  Dr.  Albert 
Eglash,  which  will  bear  the  title,  Creative  Restitution:  Guidance 
and  Rehabilitation  of  Offenders.  Although  concerned  mainly  with 
the  reclamation  of  legally  defined  criminals,  this  book  may  have 
important  implications  for  the  mentally  ill  as  well — if  they, 
too,  are  "offenders."  The  fact  that,  in  the  case  of  criminals, 
confession  or  at  least  "conviction"  has  already  occurred  might 
seem  to  make  the  total  task  of  rehabilitation  easier  here  than 
with  the  mentally  ill;  but,  being  scZf-condemned,  the  latter 
may,  for  this  reason,  have  potentialities  which  at  least  the 
criminal  psychopath  is  commonly  supposed  to  lack.  Also,  as  an 
emendation  to  what  has  been  said  in  this  paper,  it  should  be 
added  that  there  is  no  intimation  here  that  the  particular 
"crimes"  to  which  the  mentally  ill  confess  have  necessarily 
occurred.  As  Tim  Wilkins  observes  (in  a  part  of  his  paper 
which  is  not  reproduced  here),  a  trivial  or  even  nonexistent 
act  may  be  reported  and  stressed  to  "cover"  the  real  misdeed 
(cf.  Stafford,  1950;  Mowrer,  1953;  Fliess,  1957).  Some  psy- 
chiatrists are  of  the  opinion  that  it  is  a  mistake  to  encourage 
(or  even  permit)  a  psychotic  individual  to  talk  about  the  evil 
acts  he  has  committed,  on  the  assumption  that  even  though 
he  may  start  with  valid  reports  he  will  soon  progress  to  imagi- 
nary "crimes"  and  thus  become  increasingly  delusional  and  dis- 
oriented. Two  considerations  are  pertinent  here:  (a)  If  a 
therapist  took  the  patient's  first  report  of  wrong-doing  seriously 
and  immediately  started  thinking  with  the  patient  about  a  plan 
of  restitution  (instead  of  dismissing  it  as  unimportant),  perhaps 
the  patient  would  not  need  to  compound  his  real  sins  with 
fabricated  ones;  and  (b)  if  a  patient  starts  with  a  fabrication, 
might  it  not  be  profitable  to  suggest  that  he  try  to  return  to 
a  less  dramatic  but  more  tangible  and  real  action  that  may 
have  generated  guilt? 


I 


Psychotherapy  and  the  Problem 

of  Values  in  Historical  Perspective 

or, 

The  Devil  and  Psychopathology* 

I- 

One  of  the  reasons  for  caution  in  accepting  the  hy- 
pothesis that  mental  illness  has  a  moral  basis  is  the 
ubiquity  of  the  contrary  view,  that  it  is  indeed  an  illness 
and  unrelated  to  anything  for  which  the  individual  so 
afflicted  might  be  held  accountable.  Either  the  illness  in- 
terpretation is  essentially  sound  or  else,  if  erroneous,  it 
must  be  examined  and  explained  as  one  of  those  remark- 
able anomalies  of  which  the  history  of  culture  is  not, 
alas,  without  precedent.  Here  we  extend  the  effort  al- 
ready begun,  in  Chapter  6,  to  plumb  the  historical  depths 
of  the  problem  and  in  this  way,  hopefully,  discover  cir- 
cumstances which  will  shed  new  and  much-needed  light 
on  certain  present-day  perplexities. 

This  inquiry  also  brings  us  back,  once  again,  to  the 
question  of  the  nature  of  The  Unconscious;  and  on  the 
surmise  that  it  is  benevolent,  rather  than  evil  (as  Freud- 
ian theory  would  have  it),  the  possibility  opens  up  for  a 
new  synthesis  of  depth  psychology  and  religion:  namely, 
that  The  Unconscious,  thus  reconceived,  is  akin  to  what 
has  otherwise  been  known  as  The  Holy  Spirit.  This  per- 
ception of  the  situation  is  congruent  with  and  a  develop- 
ment of  the  general  position  adumbrated  in  Chapter  2. 
Such  a  re-evaluation  and  re-interpretation  of  The  Un- 
conscious may  go  far,  not  only  to  achieve  such  a  rap- 
prochement, but  also  to  dispell  the  pessimism  and  im- 
potence which  have  long  beset  the  whole  domain  of 
psychopathology. 

*  Initially  prepared  for  a  symposium  on  "Psychotherapy  and 
Values"  held  at  Ohio  State  University,  May  28-29,  1959,  this 
paper  was  also  presented  at  the  University  of  Minnesota,  April 
16,  under  the  auspices  of  the  Department  of  Psychology,  and 
later  served  as  the  second  of  the  1960  Earl  Lectures,  on 
"Psychoanalysis  and  the  Judeo-Christian  Ethic." 

103 


104  The  Crisis  in  Psychiatry  and  Religion 

In  a  related  paper  [Chapter  8]  the  writer  has  suggested 
that  we  have  seriously  erred  in  interpreting  guilt,  clini- 
cally, as  mere  gm\t  feeling  rather  than  as  a  reality-based 
state  stemming  from  palpable,  incontestable  misconduct. 
In  support  of  this  view,  a  paper  entitled  *'A  New  Theory 
of  Schizophrenia"  by  an  anonymous  author  (1958)  is 
cited  in  which  the  position  is  taken  that  schizophrenia  is 
typically  a  condition  in  which  a  person  is  driven  by  a  sort 
of  progressive  terror  lest  his  sins  find  him  out.  Then,  in 
an  account  of  a  dramatic  interview  with  a  young  woman 
known  as  Joan  (Standal  &  Corsini,  1959),  we  see  how 
great  the  pressure  may  be,  in  some  schizoid  individuals, 
to  disclose  their  misconduct  and  thus,  hopefully,  find 
peace  and  reconciliation.  But  confession,  as  we  know, 
may  bring  transitory  relief  without,  however,  effecting 
a  permanent  cure.  This  consideration  is  exemplified  in  a 
case  history  recently  published  by  Boisen  (1958),  in 
which  a  man  becomes  emotionally  disturbed  and  con- 
fesses infidelity  and  other  serious  breaches  of  morality  to 
his  wife;  but,  far  from  finding  an  honest  confession  good 
for  his  soul,  this  man  becomes  even  more  disturbed  and 
has  to  be  hospitalized.  Boisen's  interpretation  of  this 
course  of  events  goes  as  follows. 

The  emotional  disturbance  was  not  the  result  but  the 
precondition  of  the  confession.  In  his  normal  state  of  mind 
confession  would  have  been  impossible.  But  the  profound 
emotion  forced  the  confession,  just  as  nature's  healing  power 
produces  a  boil  or  an  abscess  and  then  lets  the  poison  matter 
out.  .  .  .  And  if  it  took  some  time  for  this  powerful 
emotion  to  subside,  that  is  hardly  to  be  wondered  at 
(pp.  5-6). 

In  other  words,  the  view  here  set  forth  by  Boisen  is 
that  by  the  time  an  internal  crisis  reaches  a  point  where 
it  is  powerful  enough  to  prompt  a  confession,  it  may  have 
gained  so  much  momentum  that  it  "carries"  the  person 
past  the  functional  objective,  which  is  confession  and  the 
attainment  of  openness.  In  the  paper  first  cited,  I  have 
suggested  the  alternative  possibility  that  disturbance 
often  continues  beyond  the  point  of  confession  (and  thus 
makes  confession  seem  useless  and  even  harmful)  for 
the  reason  that  confession  is  not,  of  itself,  dynamically 
sufficient  and  must,  in  many  instances,  be  accompanied 


i 


Psychotherapy  and  the  Problem  of  Values    105 

by  some  form  of  atonement  or  expiation.  Where  this  de- 
mand is  consciously  recognized,  the  individual  may  make 
a  profound  resolution  or  "vow"  v^hich  will  alter  the  en- 
tire course  of  his  life  and  thus  ''save"  him;  but  where 
the  needs  of  the  situation  are  not  so  well  understood,  it 
is  as  if  the  unconscious  forces  drive  the  individual  into 
manifest  insanity  (and  hospitalization — or  worse)  as  the 
punishment,  suffering,  and  humiliaton  he  must  endure 
before  he  can  again  (if  ever)  comfortably  face  himself 
md  others. 

If,  in  the  neurotic  or  psychotic  individual,  guilt  is  real 
rather  than  fancied,  the  whole  logic  and  strategy  of 
secular  psychotherapy  has  to  be  reconsidered.  I  say  if  the 
^uilt  is  real.  This  is  a  question  of  fact  which  has  been 
mswered  to  my  own  satisfaction  but  is,  of  course,  open 
to  further  investigation  by  others.  However,  granting 
that  the  psychoneurotic  individual  is  responsibly  guilty 
md  not  just  a  victim  of  false  scruples,  an  even  more 
3asic  question  arises  as  to  why  Western  civilization  ever 
:ame  to  doubt  or  deny  the  relationship  between  guilt, 
^eal  guilt,  and  psychopathology.  This  question  can,  I 
relieve,  be  answered  only  in  the  light  of  certain  broad 
listorical  developments,  which  we  shall  explore  in  the 
pages  that  follow. 

[.  THE   REFORMATION  AND   THE   RISE 
OF   SECULAR   PSYCHOTHERAPY 

Prior  to  the  Protestant  Reformation,  no  one  (relatively 
jpeaking)  doubted  the  reality  of  guilt.  It  did  not  matter 
ivhether  you  felt  guilty  or  not;  if  you  had  acted  in  cer- 
tain ways,  done  certain  things,  you  took  it  for  granted 
that  you  must  confess  and  obtain  forgiveness.  Otherwise, 
i^our  soul  was  in  mortal  danger. 

Martin  Luther  and  the  other  Reformers,  of  course, 
changed  all  this.  There  had,  it  seems,  been  widespread 
ibuses  and  corruption,  of  a  kind  not  without  historical 
precedent.  For  some  time  prior  to  the  Reformation,  re- 
demption from  guilt  required  not  only  that  the  individual 
:onfess  and  do  ordinary  penance  but  that,  in  addition,  he 
buy  special  "indulgences,"  for  himself  and  also  for  others 
3ear  to  him  who  might  now  or  at  some  future  time  be 
in   Purgatory    (Bainton,    1950).   Here  one   can  hardly 


106  The  Crisis  in  Psychiatry  and  Religion 

escape  being  reminded  of  the  scene  in  the  Temple  where 
Christ  scourged  the  moneychangers  for  their  traffic  in 
forgiveness.  This  outburst,  probably  more  than  any  other 
single  act  or  combination  of  acts  in  the  life  of  Christ, 
turned  the  entrenched  forces  of  orthodox  Judaism  against 
him  and  led  to  his  execution.  Only  by  the  most  improb- 
able combination  of  circumstances  did  Luther  survive 
the  fury  which  his  criticisms  and  insubordination  re- 
leased; and  if  one  holds  that  the  revolution  which  fol- 
lowed was  less  momentous  than  the  Christian  "reforma- 
tion/' who  can  say  what  would  have  happened  if  Luther, 
too,  had  been  martyred? 

As  the  Protestant  Reformation  became  consolidated, 
it  was,  of  course,  inevitable  that  sweeping  changes  would 
be  instigated  with  respect  to  confession  and  penance. 
Milder  changes  were  readily  imaginable;  but  both  prac- 
tices were,  in  effect,  abolished.  Grace,  it  was  argued,  is 
not  dependent  upon  other  men  but  comes  from  God 
alone.  Therefore,  you  were  to  take  your  case  to  God,  in 
prayer,  and  ask  for  his  forgiveness  directly,  without 
priestly  intervention.  This  arrangement  was  regarded 
as  a  great  stroke  of  genius.  And  I  can  remember  my  own 
father  telling  me,  as  a  child,  a  ''joke"  which  went  as 
follows.  For  some  time  a  small  boy  had  been  given  a 
dollar  every  month  and  told  to  go  to  the  priest  for  con- 
fession. Finally,  the  boy  became  curious  and  asked  his 
parents  who  confessed  the  priest.  The  answer  was,  the 
Bishop.  Who  then,  he  asked,  confessed  the  Bishop?  The 
Cardinal,  came  the  reply.  Who  confessed  the  Cardinal? 
The  Pope.  And  who  confessed  the  Pope?  No  one  con- 
fessed the  Pope,  the  boy's  parents  told  him;  he  took  his 
sins  to  God.  To  which  the  boy,  with  a  flash  of  inspira- 
tion, exclaimed:  ''I  think  I'll  do  as  the  Pope  does;  I,  too, 
will  take  my  sins  directly  to  God  and  save  my  dollar!" 

This  new  provision  for  a  short-cut  to  God  and  absolu- 
tion was  supposedly  a  great  innovation,  liberation,  and 
triumph.  But  history  may  yet  show  that  it  was  instead  a 
grim  and  costly  error.  There  can  surely  be  no  denying 
that,  on  the  whole.  Protestantism  has  handled  the  prob- 
lem of  guilt  very  badly.  It  has  left  its  followers  in  a  state 
which  perhaps  made  them  "creative"  and  "ambitious" 
in  a  feverish,  unhealthy  way;  but  it  has  also  disposed  us 


Psychotherapy  and  the  Problem  of  Values     107 

to  the  mass  neurosis  and  pervasive  anxiety  which  are  so 
much  a  part  of  the  modem  scene.^ 

Gradually  Protestantism  is  recognizing  this  ambiguity 
in  its  doctrines  and  practices  and  is  today  in  the  process 
Df  reinstituting  confession.  If  this  assertion  seems  rash,  I 
ivould  cite  the  development  of  ''confession  to  a  Christian 
brother,"  as  advocated  by  Deitrich  Bonhoeffer  (1954),. 
in  his  book.  Life  Together,  and  now  practiced  in  the 
Serman  Lutheran  Church.  But,  even  more  pertinently,  I 
ivould  call  attention  to  the  pervasive  recourse  to  "pastoral 
counseling"  in  this  and  other  countries,  which,  although 
it  has  the  trappings  of  secular  psychotherapy,  is  surely 
but  a  disguised  return  of  the  confessional  (see  especially 
Meehl  et  al,  1958,  pp.  68-69).  [See  also  Chapters  11 
and  12.] 

However,  since  pastoral  counseling  has  been  so  largely 
inspired  by  and  patterned  upon  secular  psychotherapy,  it 
is  not  surprising  that  it,  too,  has  important  shortcomings. 
Secular  psychotherapy,  we  must  remember,  does  not  really 
beheve  in  guilt,  only  guilt  feelings  (or  a  "guilt  sense"; 
White,  1956);  and  the  aim  of  the  type  of  "confession"" 
which  it  encourages,  i.e.,  free  association,  is  "insight"" 
rather  than  repentance  and  restitution.  Moreover,  as 
Bonhoeffer  (1948)  in  his  book.  The  Cost  of  Disciple- 
shipy  argues.  Protestantism  has  itself  really  abandoned 

^In  a  footnote  Fromm  (1955)  says:  "All  figures  show  that 
Protestant  countries  have  a  much  higher  suicide  rate  than 
Catholic  countries.  This  may  be  due  to  a  number  of  factors 
inherent  in  the  difference  between  the  Catholic  and  Protestant 
religions,  such  as  the  greater  influence  which  the  Catholic  re- 
ligion has  on  the  life  of  its  adherents,  the  more  adequate  means 
to  deal  with  a  sense  of  guilt  employed  by  the  Catholic  Church, 
etc.  But  it  must  also  be  taken  into  account  that  the  Protestant 
countries  are  the  ones  in  which  the  capitalistic  mode  of  pro- 
duction is  developed  further,  and  has  molded  the  character  of 
the  population  more  completely  than  in  the  Catholic  countries,, 
so  that  the  difference  between  Protestant  and  Catholic  countries 
is  also  largely  the  difference  between  various  stages  in  the 
development  of  modern  Capitahsm"  (p.  151).  Therefore,  the 
little  story  related  above  is  doubly  illuminating:  it  shows  not 
only  the  reduced  capacity  of  Protestantism  for  handling  in- 
dividual guilt  but  also  its  encouragement  of  thrift  and  material 
prosperity. 


108  The  Crisis  in  Psychiatry  and  Religiok 

the  strategy  of  confession  and  atonement  in  favor  oi 

what  he  calls  the  doctrine  of  "cheap  grace." 

I 

Cheap  grace  is  the  preaching  of  forgiveness  without  re* 
quiring  repentance,  baptism  without  Church  discipline,  Com^ 
munion  without  confession,  absolution  without  contrition. 
Cheap  grace  is  grace  without  discipleship,  grace  without  the 
Cross,  grace  without  Jesus  Christ,  living  and  incarnate.  .  . 

Costly  grace  is  the  gospel  which  must  be  sought  agaiiJ 
and  again,  the  gift  which  must  be  asked  for,  the  door  aH 
which  a  man  must  knock.  \ 

Such  grace  is  costly  because  it  calls  us  to  follow,  anq 
it  is  grace  because  it  calls  us  to  follow  Jesus  Christ.  It 
is  costly  because  it  costs  a  man  his  life;  and  it  is  graai 
because  it  gives  a  man  the  only  true  life.  It  is  costly  be 
cause  it  condemns  sin,  and  grace  because  it  justifies  the  sinne; 
(pp.  38-39). 

Most  pastoral  counseling,  as  we  know  it  today,  there 
fore  falls  short,  as  does  secular  psychotherapy,  of  th(; 
crucial  and  ultimate  step  in  the  quest  for  salvation  anc 
personal  wholeness.  If  one  takes  the  neurotic's  guilt  se 
riously,  that  is,  if  (as  now  seems  likely)  "neurosis"  h 
just  a  medical  euphemism  for  a  "state  of  sin"  and  socia 
alienation,  therapy  must  obviously  go  beyond  men; 
"counseling,"  to  self-disclosure,  not  just  to  a  therapist  oi 
counselor,  but  to  the  "significant  others"  in  one's  life 
and  then  on  to  active  redemption  in  the  sense  of  th< 
patient's  making  every  effort  within  his  power  to  undc 
the  evil  for  which  he  has  previously  been  responsible. ^ 

^The  Catholic  Church  has,  of  course,  always  taken  guili 
seriously  to  the  extent  of  holding  to  the  necessity  of  con 
trition,  confession,  and  satisfaction  or  penance  {Catholu 
Almanac,  1959  p.  277).  And  so  the  question  is  sometime; 
asked.  Why  are  Catholics  not  more  protected  than  they  arf 
from  personality  disturbance,  if  the  management  of  guilt  anc 
mental  health  are  related?  The  answer  seems  to  be:  (a) 
many  Catholics  do  indeed  enjoy  unusually  good  mental  health 
(b)  some  Catholics — and  indeed  their  confessors — are  per 
functory  about  confession  and  penance,  i.e.,  the  punishmeni 
often  does  not  fit  the  crime,  psychologically;  and  (c)  the  Cath 
olic  Church  identifies  contrition,  confession,  and  penance  as  i 
sacrament,  whose  central  aim  is  other-worldly  salvation  rathe 
than  mental  health  or  adjustment  in  this  life.  Therefore,  Cathol 
icism  provides  no  clear  test,  either  in  practice  or  in  theory,  o 
what  confession  and  penance  can  do  in  a  more  naturalistic  way 


Psychotherapy  and  the  Problem  of  Values     109 

At  this  juncture  it  is,  of  course,  easy  to  get  involved 
in  a  tedious  theological  debate  as  to  whether  salvation 
is  by  "good  works"  or  by  "grace  alone."  For  myself,  I 
have  no  desire  to  argue  the  point  but  will  merely  state 
that  I,  personally,  take  my  stand  with  the  Apostle  James 
and  Deitrich  Bonhoeffer,  against  the  Apostle  Paul  and 
Martin  Luther,  or  at  least  against  the  extreme  interpreta- 
tions sometimes  put  upon  their  teachings.  Be  it  granted 
that  it  ill  becomes  a  man  to  proclaim  his  own  righteous- 
aess — this,  surely,  is  a  judgment  for  others  to  render.  But 
to  assume  that  grace  or  redemption  or  change  comes  only 
as  a  result  of  divine  election  or  selection  is,  to  my  way  of 
thinking,  to  cast  a  hopeless  blight  on  the  whole  problem 
[see  Chapter  11;  also  Mowrer,  1961]. 

No  other  therapeutic  or  "redemptive"  movement, 
within  the  church  or  without,  has  in  recent  times  been  so 
successful  as  Alcoholics  Anonymous.  Here  guilt  is  seen  as 
basic  and  real;  and  its  open  admission  is  regarded  as  an 
indispensable  first  step,  to  be  followed  by  a  definite 
program  of  good  works  and  restitution.  Sometimes,  when 
the  accomplishments  of  Alcoholics  Anonymous  are  al- 
luded to,  it  is  asked:  But  why  was  the  Oxford  Group  not 
also  a  success?  Up  to  a  point  the  Oxford  Group  was  a 
success  (see  Glark,  1951);  and  that  point  was  that  it 
encouraged  confession  and  openness  but  had  no  provi- 
sion for  taking  its  members  on  from  there.  If  it  did  noth- 
ing more,  the  movement  deserves  credit  for  having  in- 
spired the  formation  of  AA,  where  the  weakness  of  pure 
Buchmanism  is  offset  by  a  clearly  specified  program  of 
"missions"  and  mercy. 

The  trial  which  AA  has  blazed  is  the  only  one  down 
iwhich  I  can  at  present  gaze  and  see  anything  that  looks 
'like  the  road  to  the  future.  How  AA  principles  can  be 
jadapted  or  modified  to  meet  the  needs  of  other  kinds  of 
|:;onfused  and  suffering  people  is  not  fully  clear  to  me. 
IBut  I  am  as  sure  as  I  can  be  of  anything  that  no  therapy 
[will  be  radically  and  broadly  successful  which  does  not 
itake  the  neurotic's  guilt  seriously  and  does  not  help  him 


For  a  quite  remarkable,  and  unusual,  attempt  to  deal  with  the 
laturalistic  (psychological)  implications  of  confession  in  the 
"Catholic  context,  see  Wilson   (1954)    [see  also  Chapters   11 

id  12]. 


110  The  Crisis  in  Psychiatry  and  Religion 

admit  his  errors  openly  and  find  ways  to  work  in  dead 
earnest  to  rectify  and  compensate  for  them. 

As  an  active  churchman,  I  beheve  that  the  concept  o£ 
God  is  vital  and  meaningful  and  that  the  so-called  'Verti- 
cal dimension/'  between  God  and  man,  is  vital  and  mean- 
ingful; but  I  do  not  believe  that  this  relationship  can  be 
either  vital  or  meaningful  if  it  is  not  complemented  and, 
indeed,  often  preceded  by  serious  concern  on  the  part  of 
the  individual  with  the  horizontal  dimension,  namely, 
the  relation  of  man  to  man.  The  total  situation  has  welli 
been  termed  ''triangular,"  with  God,  the  individual,  and 
one's  fellowmen  at  the  three  corners.  The  nature  of  the 
relationship  is  also  well  described  by  the  following  lines: 

I  sought  my  soul  and  sought  My  God, 
But  neither  could  I  see; 
And  then  I  sought  my  neighbor, 
And  then  I  found  all  three. 

Intrepid  and  bold  as  the  Protestant  Reformation  un- 
doubtedly was  in  many  ways,  one  can  hardly  avoid  the 
judgment,  at  this  vantage  point  in  history,  that  it  was 
also  crucially  incomplete  (cf.  Section  VI;  also  Tillich, 
1948).  If,  for  the  third  time  in  the  past  two  thousand 
years,  there  is  again  widespread  mercenary  traffic  in  for- 
giveness, perhaps  this  scandal,  no  less  than  the  former 
ones,  will  prompt  changes  of  a  radical  and  "redemp- 
tive" kind. 

II.    THE   HISTORICAL    SITUATION 
AND   FREUDIAN   PSYCHOANALYSIS 

In  his  Autobiography,  Freud  (1935) — writing  with  his 
usual  plausibility  and  charm — speaks  of  the  circum- 
stances, both  personal  and  cultural,  which  prompted  the 
development  of  that  remarkable  body  of  theory  and  prac- 
tice which  was  to  be  known  as  psychoanalysis.  By  the 
end  of  the  19th  Century,  the  church,  as  we  have  seen, 
had  largely  abandoned  its  interest  and  claim  to  com- 
petence in  the  area  of  psychopathology;  and  medicine 
had  an  essentially  organic  conception  of  the  problem, 
with  the  result  that  there  were,  as  Freud  observed 
"crowds  of  neurotics,  whose  numbers  seemed  further  mul- 
tiplied by  the  manner  in  which  they  hurried,  with  their 


Psychotherapy  and  the  Problem  of  Values     111 

troubles  unsolved,  from  one  physician  to  another"   (p. 

27). 

Being  a  Jew  in  a  nominally  Christian  country,  Freud 
experienced  one  disappointment  and  frustration  after  an- 
other in  his  original  hope  of  securing  an  academic  posi- 
tion; and  finding  himself  thus,  as  he  said,  ''forced  into 
the  Opposition"  (p.  24),  the  outcast  Jewish  doctor 
eventually  began,  understandably  enough,  to  direct  his 
professional  attention  to  what  we  may  also  call  the  "out- 
casts" among  patients.  The  superabundance  of  neurotic 
individuals  who  were  seeking  Something  and  not  finding 
it  and  the  accident  of  Freud's  finding  himself  now  aligned 
with  "the  Opposition"  provided  the  sour  soil  in  which 
psychoanalysis  germinated  and  began  its  growth.  "My 
therapeutic  arsenal  [in  the  beginning],"  Freud  said,  "con- 
tained only  two  weapons,  electrotherapy  and  hypnotism, 
for  prescribing  a  visit  to  a  hydropathic  establishment 
after  a  single  consultation  was  an  inadequate  source  of 
income"  (p.  25).  And  when,  at  length,  Freud  became 
disgusted  with  both  electrotherapy  and  hypnotism,  he 
simply  began  listening  to  his  patient  talk.  From  this 
seemingly  inauspicious  beginning  came  the  now  well- 
known  analytic  technique. 

As  we  shall  presently  see,  the  solution  which  Freud 
ultimately  offered  to  the  emotionally,  morally,  and 
spiritually  troubled  person  is  very  far  from  a  religious 
solution;  and  we  are  now  beginning  to  supect  that  it  is 
also  very  far  from  a  soundly  scientific  one.  Yet  the  fact  is 
that  Freud,  and  the  disciples  whom  he  soon  attracted,  at 
least  walked  in  the  Valley  of  the  Shadow  with  these  un- 
I happy,  distraught  individuals,  in  a  way  which  neither  the 
ordinary  physician  nor  the  typical  clergyman  of  the  time 
had  been  willing  to  do.  Surely  it  is  not  without  deep 
significance  that  a  theologian  recently  remarked:  "Re- 
gardless of  whether  Freud  was  right  or  wrong  in  his 
theory,  he  at  least  tried  to  minister  to  a  class  of  sufferers 
ion  whom  the  church,  Protestant  and  Catholic  alike,  had 
I  turned  its  back.  This  is  to  our  inescapable  and  enduring 
ishame!"  (De  Wire,  1958). 

The  end  of  the   19th  Century  found  the  Catholic 

Church  still  licking  its  wounds  from  the  Reformation 

\  and  smarting  from  the  memory  of  its  folly  in  dealing  with 

Galileo.  And,  in  the  decades  just  past,  the  credibility  of 


112  The  Crisis  in  Psychiatry  and  Religion 

the  Church  had,  of  course,  been  further  challenged  by 
Darwinian  evolution.  While  Protestantism  had  perhaps 
not  shown  the  same  degree  of  opposition  to  science,  it 
too  was  in  a  precarious  state  because,  among  other  rea-j 
sons,  of  its  ineffective  handling  of  the  problem  of  guilt. ! 
Therefore,  when  Freud,  in  the  name  of  science,  began! 
to  proclaim  discoveries  in  the  realm  of  mind  as  revolu-! 
tionary  as  those  of  Copernicus  and  Calileo  in  astronomy  \ 
and  of  Darwin  in  biology,  there  was  little  religious  vitality 
to  oppose  him. 

Although  Freud  thus  spoke  in  the  name  of  Science, 
and  eschewed  all  theological  considerations,  it  is  no  ac- 
cident that  he  was  a  Jew  and  that  psychoanalysis,  as' 
ideology  and  as  therapy,  developed  as  it  did.  Having 
suffered  repeated  rebuffs  and  disappointments  at  the 
hands  of  what  he  referred  to  as  the  ''compact  majority," 
Freud  had  no  reason  to  be  anything  but  gratified  by  the 
embarrassment  and  failures  of  organized  religion;  and  he 
let  no  opportunity  pass  for  striking  at  what  was  not  only 
a  personal  affront  but  also,  as  he  conceived  it,  the  enemy 
of  all  mankind  (cf.  Freud,  1928).  Having  been  excluded, 
or  at  least  so  he  imagined,  from  the  opportunities  and 
privileges  which  would  have  perhaps  been  open  to  him 
as  a  Christian,  he  gave  up  trying  to  function  within  con- 
ventional boundaries  and  developed  what  he  himself, 
with  magnificent  understatement,  termed  "a  certain  de- 
gree of  independence  of  judgment"  (p.  11). 

III.    FREUD   AND   THE   KABBALISTIC   TRADITION 

Just  how  great  was  Freud's  disaffection  from  conven- 
tional streams  of  thought  and  values  becomes  clear  when 
we  discover  that  not  only  was  he  alienated  with  respect 
to  Christianity  but  also  from  the  main  currents  of 
Judaism.  In  a  remarkable  book  by  David  Bakan  (1958a) 
which  will  be  considered  more  fully  in  the  next  section, 
we  learn  that  Freud's  family,  together  with  many  other 
Viennese  Jews,  had  migrated  from  Galicia,  which,  says 
Bakan,  "had  been  saturated  with  Jewish  mysticism"  (p. 
80),  of  the  Kabbalistic  variety.  This  sect,  or  splinter 
group,  differed  from  traditional  rabbinical  Judaism  in  a 
number  of  ways  which,  as  Bakan  ingeniously  shows, 
strikingly  anticipate  important  and  distinguishing  features 


Psychotherapy  and  the  Problem  of  Values     113 

of  psychoanalysis.  The  following  excerpts  capture  some 
of  the  salient  features  of  Kabbala  and  suggest  a  probably 
more  than  coincidental  relationship  to  psychoanalysis. 

One  of  the  meanings  of  the  word  Kabbala  is  tradition  in 
.  a  way  which  connotes  oral  transmission.  Another  meaning  is 
acceptance  as  the  mystics  are  accepted  before  God.  A  third 
meaning  of  the  term  is  that  which  is  received,  suggesting  its 
revelatory  character.  The  Kabbala  is  something  referred  to 
as  the  Secret  Wisdom  to  indicate  that  it  is  comprehensible 
only  to  the  initiated.  .  .  . 

Kabbala  has  always  had  about  it  an  aura  of  danger, 
perhaps  for  good  reason.  In  the  light  of  the  later  psycho- 
analytic developments,  this  danger  may  be  best  understood 
as  that  associated  with  bringing  repressed  material  into  con- 
sciousness (p.  70). 

Recalling  our  earlier  discussion  of  the  friendship  between 
Freud  and  Fliess,  Kabbalistic  tradition  provides  a  further 
hint  concerning  the  nature  of  the  relationship.  In  his  psycho- 
analytic work,  which  we  maintain  is  Kabbalistic,  Freud 
needed  an  "associate,"  because  the  burden  of  the  Kab- 
balistic thought  is  too  difficult  for  anyone  to  bear  in  inde- 
pendent study.  .  .  . 

The  tradition  is  one  pervaded  by  a  sense  of  secrecy.  .  .  . 
The  Kabbalists  were   endowed  with   mystery  and  power 
(p.  71). 

As  will  become  increasingly  evident  in  what  follows,  a 
theory  of  repression  and  the  role  of  the  ego  in  repression 
are  already  germinal  here.  Abulafia  [a  13th-Century  Spanish 
Kabbalist]  has  essentially  two  methods  of  meditation  in  order 
to  achieve  the  desired  release  of  the  soul.  The  first  of  these 
is  an  interpretative  method  based  on  taking  liberties  with 
the  letters  of  the  alphabet  (p.  76). 

The  second  important  method  for  which  the  first  is  but 
a  preparation  is  called  "jumping  and  skipping"  [which  Bakan 
identifies  as  a  forerunner  of  the  method  of  free  association] 
(p.  77). 

Associated  with  such  meditation  is  an  intellectual  ecstasy 
identifiable  with  psychoanalytic  insight  (p.  79). 

Furthermore,  Abulafia  regards  the  Kabbalistic  teacher  as 
extremely  important,  a  harbinger  of  the  idea  of  the  trans- 
ference (p.  80). 

That  Freud  would  have  had  contact  with  Kabbalistic 
thought  and  practice  is  insured  by  the  circumstances  al- 
ready cited,  to  which  can  also  be  added  the  fact  that  dur- 


114  The  Crisis  in  Psychiatry  and  Religion 

ing  the  latter  half  of  the  19th  Century  Adolf  Jellinek, 
who  was  a  close  student  of  Kabbala,  was,  Bakan  reports, 
"the  most  popular  Jewish  preacher  in  the  city  of  Vienna 
in  his  day.  It  is  said  that  when  Jellinek  spoke  on  the  week 
end  the  Jews  of  Vienna  would  discuss  what  he  said  for 
the  whole  succeeding  week"  (p.  81). 

Hence  we  arrive  at  the  conclusion  that  Freud  not  only 
stood  apart  from  Christianity  but  that  he  had  little  af- 
finity even  for  orthodox  Judaism.  He  was,  however,  very 
probably  influenced,  consciously  or  unconsciously,  by  a 
singular  and  indeed  somewhat  sinister  variety  of  Jewish 
mysticism.  In  his  expressed  allegiance  to  science  and  in 
yet  other  ways,  Freud  revealed  also  a  sympathy  with  and 
admiration  for  classical  Greek  culture,  a  fact  which  is 
well  known.  But  the  knowledge  of  his  affiliation  with 
Kabbalism,  as  brought  out  by  Bakan,  is  new  and  puts 
psychoanalysis  into  a  surprising  context,  which  will  be 
further  considered  in  the  next  section. 

IV.    did   FREUD   ''play   THE   DEVIl"? 

It  is  remarkable  how  slow  we  sometimes  are  to  perceive 
realities  which  we  do  not  expect,  or  wish,  to  be  true.  It  | 
is  more  than  thirty  years  now  since  the  writer  first  he-\ 
came  interested  in  psychoanalysis  and  resorted  to  it,  as  a  i 
form  of  psychotherapy  and,  hopefully,  also  as  a  new  way 
of  life.  For  the  better  part  of  two  decades  he  tried  to 
make  it  ''work"  but  to  no  avail;  and  so,  little  by  little, 
he  became  critical  of  psychoanalysis  and  returned  to 
more  conventional  views  and  values.  And  this  experience 
is  today  by  no  means  uncommon.  Yet  it  is  with  a  real 
sense  of  surprise  and  even  shock  that  one  reads  the  evi- 
dence which  Bakan,  in  his  book  Freud  and  the  Jewish 
Mystical  Tradition  (1958a),  has  assembled  for  believing 
that  Freud  not  only  repudiated  Mosaic  and  Christian 
conceptions  of  God  but,  in  addition,  identified  himself 
with  the  Devil. 

That  Freud,  as  Bakan  maintains,  felt  himself  in  mortal 
conflict  with  Moses,  the  Law  Giver,  is  not,  of  itself,  sur- 
prising. Perhaps  the  most  basic  tenet  of  psychoanalysis  is 
that  neurosis  is  due  to  too  great  severity  of  the  superego; 
and  Freud  may  be  said  to  have  "invented"  psychoanalysis . 
for  the  avowed  purpose  of  combatting  conscience,  the 


Psychotherapy  and  the  Problem  of  Values    115 

superego,  the  Law,  and,  by  implication,  the  Law  Giver. 
Then,  reasons  Bakan  (1958b): 

If  Freud  conceives  of  himself  as  the  new  Lawgiver,  .  .  . 
he  must  at  one  and  the  same  time  be  like  unto  Moses,  the 
previous  Lawgiver,  whose  place  he  must  preempt,  and  must 
be  destructive  of  Moses.  The  new  Lawgiver  must  revoke 
the  older  Law.  The  identification  with  Moses  turns  into  its 
opposite,  the  destruction  of  Moses"  (pp.  323-24). 

The  Talmud  and  the  other  Rabbinical  writings  constitute 
an  elaboration  of  dicta  of  the  Mosaic  code,  which  the  Ortho- 
dox Jew  takes  upon  himself  to  guide  his  life  at  every  moment 
and  in  connection  with  every  action.  In  a  word,  Moses  is 
representative  of  the  superego,  the  force  generated  within 
the  individual  to  keep  him  from  "instinctual  gratification." 
The  force  which  maintains  renunciation  of  instinctual  gratifi- 
cation is  the  fear  of  punishment.  In  the  allegory  of  the 
discussion  of  a  statue  [of  Moses,  by  Michelangelo]  Freud 
is  saying  that  the  feared  punishment  will  never  eventuate. 
The  superego  is  restrained  (p.  324). 

Freud's  repeated  affirmation  of  his  Jewish  identity  becomes 
illuminated  through  Moses  and  Monotheism.  If  it  is  the 
Jew  who  carries  the  burden  of  the  historical  superego,  then 
it  is  only  a  Jew  who  can  really  remove  the  sense  of  sin.  We 
recall  in  this  connection  Freud's  assertion  that  psycho- 
analysis could  only  have  been  created  by  a  Jew;  in  a  letter 
to  his  Swiss  friend  Oskar  Pfister  he  wrote,  ".  .  .  by  the 
way,  how  comes  it  that  none  of  the  godly  ever  devised 
psychoanalysis  and  that  one  had  to  wait  for  a  godless  Jew?" 
If  the  Jews  represent  the  authority  of  the  Law,  only  a  Jew 
can  declare  that  the  Law  is  dead.  Psychoanalysis,  in  this 
larger  cultural  sense,  may  be  viewed  as  a  fundamental  effort 
to  modify  the  classical  image  of  the  Jew.  .  .  .  Thus  Freud 
plays  the  role  of  a  new  Moses  who  comes  down  with  a  new 
Law  dedicated  to  personal  psychological  liberty   (p.   329). 

For  Freud  and  psychoanalysis  the  task  of  treating 
neurotic  individuals  thus  became  at  one  with  the  libera- 
tion of  mankind  from  the  Mosaic  Law,  a  task  which 
pakan   (1958a)   characterizes  as  ''Messianic."  He  says: 

One  of  the  critical  features  of  Messianism  is  its  goal  of 
leading  people  out  of  slavery  and  oppression.  Thus  Freud's 
whole  effort  at  the  creation  of  psychoanalysis  may  be  viewed 
as  Messianic  in  this  respect  (p.  170). 

But  since  the  oppressor  was  none  other  than  the 
mighty  Moses  and  since  his  traditional  adversary  was  the 


116  The  Crisis  in  Psychiatry  and  Religion 

Devil  himself,  it  is  logical — though  none  the  less  astonish- 
ing— that  Freud  should  have  consciously  identified  him- 
self with  the  Devil.  At  the  end  of  Chapter  22  Bakan  i 
quotes  Freud  as  having  once  remarked  to  colleagues: 

Do  you  not  know  that  I  am  the  Devil?  All  my  life  I  have 
had  to  play  the  Devil,  in  order  that  others  would  be  able  to 
build  the  most  beautiful  cathedrals  with  the  materials  that 
I  produced   (p.  181). 

There  then  follow  the  five  chapters  which  comprise 
Part  IV  of  the  Bakan  book,  entitled  'The  Devil  as  Sus- 
pended Superego."  In  1923  Freud  published  a  remark- 
able paper  on  "A  Neurosis  of  Demoniacal  Possession  in 
the  Seventeenth  Century,"  in  which  he  relates  the  story 
of  the  painter  Christoph  Haitzmann,  who  in  a  period  of 
discouragement  and  depression  had  contracted  with  the 
Devil  to  be  his,  body  and  soul,  at  the  end  of  nine  years 
in  return  for  success  in  his  art  and  surcease  from  sadness. 
As  the  time  approached  for  the  contract  to  be  consum- 
mated, Haitzmann  became  increasingly  agitated  (show- 
ing symptoms  which  would  today  probably  be  regarded 
as  schizophrenic — see  Macalpine  &  Hunter,  1956)  and 
successfully  sought  priestly  intervention  and  protection. 

In  Freud  and  the  Jewish  Mystical  Tradition,  Bakan 
develops  and  convincingly  documents  the  thesis  that,  at 
least  metaphorically,  Freud  himself  had,  some  twenty- 
five  years  earlier,  entered  into  a  "Satanic  Pact"  and  that 
psychoanalysis  was  the  result  thereof.  For  a  period  prior 
to  the  publication  of  Die  Traumbeutiing  in  1900  (which 
he  always  regarded  as  his  masterpiece),  Freud  had  been 
in  a  state  of  unproductivity,  discouragement,  and  depres- 
sion (as  is  now  known  from  the  Fliess  correspondence; 
see  Bakan,  1958a,  p.  221  and  p.  224).  But  then  some 
sort  of  personal  change  or  rearrangement  of  his  emotions 
and  mental  powers  took  place;  and  we  get  more  than  a 
hint  of  what  this  change  was  from  the  motto  in  Latin 
which  appears  on  the  title  page  of  this  book.  The  quota- 
tion is  taken  from  a  passage  of  Virgil's  Aeneid  and,  when 
translated  in  its  entirety,  reads: 

Well,  if  my  powers  are  not  great  enough,  I  shall  not 
hesitate — that  is  sure — to  ask  help  wherever  help  may  be 
found.  If  the  gods  above  are  no  use  to  me,  then  I'll  move 
all  hell.  I 


Psychotherapy  and  the  Problem  of  Values     117 
And  here  Bakan  comments,  insightfully: 

If  God  is  identified  with  the  superego,  then  the  corre- 
sponding antagonistic  image  is  the  Devil,  who  dwells  iii 
hell.  As  we  have  indicated  earlier,  in  the  psychoanalytic 
relationship  the  analyst  is  at  one  and  the  same  time  the 
representative  of  the  superego  as  well  as  a  tolerant,  under- 
standing father  figure.  Now  what  is  the  Devil,  psychologi- 
cally? The  answer  is  eminently  simple,  on  one  level.  The 
Devil  is  the  suspended  superego.  He  is  the  permissive  super- 
ego. The  Devil  is  that  part  of  the  person  which  permits  him 
to  violate  the  precepts  of  the  superego  (p.  211). 

In  summarizing  Chapter  27,  Bakan  says: 

In  our  discussion  of  hypnosis,  cocaine,  and  the  transference, 
indications  of  suspension  of  the  superego  were  suggested. 
Our  introduction  of  the  Devil  idea  into  this  discussion  rounds 
out  the  great  drama  which  was  taking  place  in  Freud's  mind 
in  his  creation  of  psychoanalysis  .  .  .   (pp.  212-213). 

And  finally,  toward  the  end  of  Chapter  30,  we  read: 

The  Devil  is  then  a  cure  for  despair.  He  is  called  upon 
as  an  assertive  act  when  all  hope  is  gone.  And  in  this  sense 
also,  the  Devil  is  always  the  Tempter.  The  essential  message 
of  the  Tempter  is  that  the  anticipated  rewards  associated 
i  with  resistance  to  temptation  will  not  be  forthcoming,  that 
j  faith  is  groundless.  The  Devil  presents  the  new  hope,  and 
supports  this  promise  by  immediate  tokens  of  his  favor. 
But  since  these  tokens  themselves  bring  so  much  relief,  one 
permits  oneself,  in  his  relationship  to  the  Devil,  to  be  thus 
taken  in  (by  the  Devil),  since  he  feels  that  he  has  already 
been  taken  in  (by  God). 

In  more  secular  terms,  Freud  suffered  from  acute  depres- 
sions. His  self-analysis,  and  his  development  of  psychoanalysis, 
were  the  cure  for  his  depression.  His  practice  had  already 
provided  him  with  ample  evidence  that  diseases  which  other 
people  were  suffering  from,  for  which  there  was  no  other 
hope,  could  be  cured  by  such  means.  In  his  despair  over 
making  a  living,  and  in  his  despair  over  anti-Semitism,  he 
had  'little  or  nothing  to  lose"  by  his  "audacity."  Further- 
more, this  new  set  of  methods  which  he  was  producing  held 
out  the  promise  of  bringing  patients  to  him  and  so  solving 
at  least  the  problem  of  making  a  living  (p.  236). 

Thus  does  Bakan  develop  and  document  his  conten- 
tion that  Freud,  at  least  metaphorically,  "played  the 
Devil" — ^but  that  he  did  so  in  a  good  cause.  However,  as 


118  The  Crisis  in  Psychiatry  and  Religion 

we  know,  "playing  the  Devil"  also  carries  the  implication 
of  eventually  causing  disaster!  It  is  this  aspect  of  the 
situation  to  which  we  now  turn  our  attention. 

V.    THE   ROLE   OF   THE   PSYCHOANALYST 

THERAPIST   OR   TEMPTER? 

Today  no  one,  of  course,  "believes"  in  the  Devil  in 
the  sense  in  which  he  was  conceived  in  the  Middle  Ages. 
Instead,  we  have  come  to  "believe"  in  Freud  and  psy- 
choanalysis. But  now  we  are  confronted  by  the  astonish- 
ing possibility  that  Freud  and  his  works  are  the  20th- 
century  equivalent  of  the  Devil,  thinly  disguised.  And 
this  possibility  is  rendered  all  the  more  palpable  by  the 
fact  that  Bakan,  who  has  so  vividly  brought  this  pos- 
sibility to  our  attention,  is  himself  an  admirer  and  de- 
fender of  Freud.  The  logic  by  which  Bakan  reconciles 
this  apparent  contradiction  and  justifies  his  "audacity" 
cannot  be  reproduced  here,  partly  because  it  is  intricate 
and  partly  because  I  am  not  sure  I  fully  understand  it. 
But  we  can  and  should  note  one  or  two  additional  bits 
of  evidence  which  Bakan  (1958a)  adduces  in  support  of 
his  remarkable  thesis: 

The  question  of  the  seriousness  of  Freud's  entry  into  the 
Satanic  Pact  may  well  be  raised.  Freud  was  a  modern  man 
who  did  not  believe  in  supernatural  beings  (p.  215). 

Perhaps  precisely  because  Freud  did  not  accept  the  super- 
natural reality  of  the  Devil,  he  could  permit  himself  the 
full  exploitation  of  the  metaphor.  We  may  imagine  that 
at  times  the  sense  of  possession  became  quite  strong;  and 
it  is  this  feeling  of  possession  that  Freud  is  analyzing  in  his 
paper  [ostensibly  dealing  with  the  17th-Century  painter, 
Christoph  Haitzmann]  (219). 

"According  to  Bakan,  both  Freud  and  Haitzmann  had 
sought  the  help  of  the  Devil  in  their  struggle  against 
depression,  which  is  a  work  of  the  superego.  Therefore, 
metaphorically  at  least,  the  powers  of  the  Devil  might 
be  thought  of  as  generally  useful  in  the  campaign  against 
the  superego,  a  campaign  which  is  supposed  by  psycho- 
analysis to  be  so  essential  to  the  treatment  of  all  neurosis. 
Says  Bakan: 

Throughout  the  Middle  Ages  the  Devil  was  a  star  in  the 
great  spiritual  drama  which  was  then  taking  place.  As  Freud 


'SYCHOTHERAPY  AND  THE   PROBLEM   OF  VaLUES       119 

had  so  aptly  pointed  out,  even  though  the  Devil  is  perhaps 
no  longer  a  personage  in  the  same  sense  as  in  the  Middle 
Ages,  the  psychological  phenomena  associated  with  his  image 
are  still  current  and  important.  We  have  already  indicated 
the  psychological  significance  of  the  Devil  image  as  an  ally 
against  the  superego,  or  better,  as  its  suspension  (p.  231). 

More  prosaically  this  can  be  stated  as  follows:  The  disease 
of  the  neurotic  is  his  guilt.  This  guilt  is,  in  itself,  an  evil 
and  its  removal  is  good.  ...  If  God  is  the  guilt-producing 
image,  then  the  Devil  is  the  counterforce.  .  .  . 

As  Freud  said  in  discussing  Anatole  France's  Revolt  of 
the  Angels,  "War  will  produce  war  and  victory  defeat.  God 
defeated  becomes  Satan  and  Satan  victorious  will  become 
God"  (p.  233). 

But  enough  of  conjecture  and  finely  spun  inferences! 
Vhat,  in  actual  practice,  is  the  strategy  and  goal  of  psy- 
hoanalysis?  Analysts  have  been  a  little  hesitant  about 
mblishing  verbatim  accounts  of  what,  in  fact,  transpires 
n  analysis.  And  when,  on  occasion,  this  reluctance  has 
)een  overcome  and  verbatim  transcripts  have  appeared, 
me  understands  why  analysis,  like  a  Witches'  Sabbath, 
)rospers  best  in  an  atmosphere  of  secrecy  and  darkness. 
7he  following  excerpts,  quoted  by  de  Grazia  (1952) 
rom  a  psychoanalytic  transcription,  illustrate  the  point: 

patient:  Not  only  is  there  this  fear  of  being  in  an  intimate 
relationship  with  a  woman,  but  I  am  also  obsessed  with  the 
fear  concerning  that  blasphemous  thought.  The  reason  for 
this  seems  to  be  that  I  had  sold  myself  to  the  devil,  merely 
by  thinking  this  thought  to  myself.  It  is  a  fear  of  being 
possessed  by  the  devil.  I  know  it  is  rather  absurd  and  based 
on  the  ol<3  theology.  The  devil  seems  to  represent  all  that  is 
evil  or  bad. 

The  fear  of  selling  myself  to  the  devil  takes  my  thoughts 
back  to  a  dream  I  had  at  the  age  of  5  or  6  years.  I  was 
sleeping  with  my  mother  at  the  time.  I  woke  up  trembling 
very  violently.  I  thought  I  saw  a  phantom  fly  across  the 
room.  It  was  like  a  flame,  and  yet  it  was  like  an  imp  grinning 
i  at  me.  It  flew  across  the  room  and  out  of  the  window.  I  was 
scared  to  death. 

therapist:  What  is  the  flame  you  would  get  if  you  were 
sleeping  with  your  mother? 

patient:  Love  of  my  mother,  I  suppose. 

therapist:  What  is  the  flame  you  would  get  if  you  were 
sleeping  with  a  young  lady? 

patient:  Passion^ 


120  The  Crisis  in  Psychiatry  and  Religion 

therapist:  Would  you? 

patient:  No,  I  expect  I  should  be  scared  to  death,  and 
trembling  violently,  like  I  was  in  the  dream. 

.  .  .  Now  my  main  concern  is  this  idea  or  obsession  that 
I  am  possessed  by  the  devil. 

therapist:  Suppose  you  are? 

patient:  That  would  mean  that  one  would  lose  control 
of  one's  will. 

therapist:  What  is  natural? 

patient:  Do  you  mean  that  what  I  am  afraid  of  is  my 
own  natural  urge  to  live  a  normal  natural  life  .  .  .  ? 

And  during  the  next  session: 

patient:  Perhaps  I  am  scared  of  a  girl  because  I  am 
terrified  that  my  sexual  feelings  might  run  away  with  me, 
and  I  might  not  act  rationally. 

therapist:  What  might  you  do? 

patient:  I  might  love  her  too  much. 

therapist:  What  would  that  lead  to? 

patient:  My  desire  would  be  to  put  my  arms  around  her, 
and  tell  her  I  love  her.  But  I  was  scared. 

therapist:  Does  that  seem  so  terrifying? 

patient:  Well,  I  might  have  sexual  intercourse  with  her: 
that  would  be  going  too  far. 

therapist:  Would  it? 

patient:  Well,  perhaps  not  as  far  as  sexual  intercourse. 
If  that  is  the  devil,  perhaps  he  is  quite  a  harmless  devil. 
Perhaps  the  sooner  I  went  to  the  devil  the  better. 

therapist:  If  that  is  all  there  is  to  it,  why  is  there  all 
this  scare? 

patient:  Apparently  all  this  time  I  have  been  afraid  of 
being  possessed  by  my  own  nature.  The  thing  I  want  more 
than  anything  else  is  to  lead  a  normal  natural  life.  Since 
coming  to  you  I  have  understood  that  this  fear  of  being 
sold  to  the  devil  is  nothing  more  or  less  than  fear  of  my 
own  nature  on  the  one  hand,  and  on  the  other  hand  a 
preference  for  it,  which  I  have  thought  was  a  preference  for 
the  devil. 

The  whole  amazing  thing  has  become  quite  plain  to  me. 
It  is  amazing  how  the  obsession  left  me  last  night  after  that 
talk  with  you  (pp.  100-102)   [cf.  Berg,  1948,  pp.  78-80]. 

A  playwrite  could  not  have  produced  a  better  script 
for  a  modern  re-enactment  of  the  temptation  and  fall  of 
man  as  it  supposedly  occurred  in  the  Garden  of  Eden. 
Here  Adam  and  Eve  were  attracted  by  the  possibility  of 


Psychotherapy  and  the  Problem  of  Values    121 

sating  of  the  fruit  of  the  Tree  of  Knowledge  but  were 
restrained  by  God's  contrary  commandment  (superego). 
But,  step  by  step,  the  Devil  showed  them  how  pleasant, 
natural,  and  harmless  eating  the  fruit  would  be.  The 
Devil  succeeded,  and  Adam  and  Eve  were  "cured"  of 
their  apple-eating  inhibition.  But  the  cure  ultimately 
proved,  of  course,  to  be  worse  than  the  "disease";  and 
this  seems  also  to  hold  for  the  fruits  of  psychoanalvsis. 
[n  one  of  the  last  papers  he  ever  wrote,  Freud  (1937) 
looked  back  upon  the  therapeutic  accomplishments  of 
psychoanalysis  and  did  not  find  them  reassuring.  Typi- 
cally, Freud  said,  patients  give  the  appearance  of  making 
a  good  recovery  and  leave  analysis;  but  then,  sooner  or 
later,  they  are  likely  to  experience  a  recurrence  of  their 
old  difficulties  or  the  outbreak  of  new  ones. 

In  studying  various  developments  and  changes  we  focus 
our  attention  entirely  on  the  result  and  we  readily  overlook 
the  fact  that  such  processes  are  usually  more  or  less  incom- 
plete, that  is  to  say,  the  changes  that  take  place  are  really 
only  partial.  A  shrewd  satirist  of  the  old  Austria,  Johann 
Nestroy,.  once  said:  "Every  advance  is  only  half  as  great  as 
it  looks  at  first."  One  is  tempted  to  think  that  this  malicious 
dictum  is  universally  valid  (p.  330). 

J  And  two  decades  later,  an  eminent  American  analyst 
;(Kubie,  1956)  was  prompted  to  confess: 

In  this  connection  I  recall  Edward  Glover's  statement 
[personal  communication]  that  analysts  sometimes  seem  to 
achieve  their  greatest  successes  when  they  are  beginners.  Even 
if  Glover's  statement  was  in  part  an  ironic  and  rueful  jest, 
it  indicates  a  mood  of  healthy  reserve  about  our  right  to 
claim  therapeutic  omnipotence  or  omniscience.  .  .  .  My  own 
observations  of  analytic  defeats  have  convinced  me  that 
basic  gaps  remain  in  our  knowledge  of  the  dynamic  processes 
both  of  illness  and  of  therapy.  .  .  . 

Only  a  few  years  ago  (although  it  seems  a  long  time  in 
my  life  as  an  analyst)  I  harbored  the  comforting  expectation 
that  increasing  analytic  sophistication  and  experience  would 
yield  a  higher  percentage  of  therapeutic  successes.  .  .  .  My 
reluctant  impression  is  that  this  hope  has  not  been  realized 
(p.  87). 

From  testimony  now  available  from  both  the  friends 
ind  the  foes  of  analysis,  it  is  clear  that,  at  best,  analysis 
iasts  a  spell  but  does  not  cure.  By  aligning  himself  with 


122  The  Crisis  in  Psychiatry  and  Religion 

the  patient's  id,  the  analyst  ( "Devil"? )  may  indeed  suc- 
ceed, as  Bakan  puts  it,  in  suspending  the  superego;  but 
the  superego  (or  conscience),  more  commonly  than  we 
might  wish  to  believe,  is  a  reflection  of  enduring  social 
realities;  and  the  advantage  we  gain  by  overcoming  it  in 
analysis  is  dearly  paid  for  later,  many  times  over.  Man's 
salvation  must  surely  come,  not  from  his  looking  and 
moving  downward,  but  from  an  upward  reach,  toward 
reconciliation  and  community,  made  by  means  of  confes- 
sion and  manifest  restitution. 


VI.    THE   END   OF   AN   ERA — ^AND   AN  ALTERNATIVE 

Even  though  Freud  today  stands  indicted  of  having 
"played  the  Devil,"  there  are  many  modern-minded  men 
and  women  who  will  not  greatly  blame  him.  By  theii 
narrowness,  bigotry,  arrogance,  sanctimony,  false  piety, 
irrealism,  supernaturalism,  and  hypocrisy,  several  genera- 
tions of  theologians  and  laymen  have  given  organized' 
religion  an  exceedingly  negative  imprint  and  reputation;! 
and  if  there  have  been  those  who  said,  "Let  the  Devilj 
take  them,"  it  can  hardly  be  wondered  at.  Galileo  ancj 
Darwin  were  primarily  scientists,  and  all  they  asked  wai; 
to  be  let  alone  to  do  their  work.  Because  of  their  partic 
ular  subject  matter,  they  were  not  greatly  interested  ir 
religious  issues,  and  became  so  mainly  to  the  end  of  try 
ing  to  protect  themselves  and  their  scientific  activitic* 
from  unwarranted  interference.  But  with  Freud  the 
situation  was  different.  His  subject  matter  was  inherentlj 
closer  to  that  of  religion;  and  if  he  was  not  to  go  alon§ 
with  religion  (as  he  obviously  had  no  intention  of  dd 
ing),  then  he  had  to  go  away  from  and  against  it,  in  a? 
emphatic  and  militant  a  way  as  possible.  Hence,  as  w^ 
have  seen,  he  played  the  Devil. 

But,  much  as  we  may  sympathize  with  both  the  per 
sonal  and  the  historical  situation  which,  as  we  may  say 
produced  a  Freud,  we  cannot  at  this  point  in  time,  regarc 
his  total  effort  as  anything  but  a  failure.  In  fact,  thi 
surely  is  the  hallmark  of  Evil:  ultimate  disaster  afte 
what  appears  to  be  great  accomplishment  and  gain.  It  i 
the  long  haul  that  provides  the  test  of  Tightness  anc 
righteousness;   and   already,   barely   two   decades   afte 


Psychotherapy  and  the  Problem  of  Values    123 

Freud's  death,  the  signs  of  confusion  and  disintegration 
in  the  movement  he  launched  are  rampant. 

During  the  same  two  decades  there  has  been  a  remark- 
able upswing  in  church  attendance  and  general  religiosity. 
But  can  we  be  sure  that  these  developments  have  as  yet 
a  clear  ideology  and  rationale?  There  is  still  a  babble  of 
tongues  in  respect  to  the  genesis  and  treatment  of  those 
profound  and,  alas,  prevalent  disturbances  of  the  human 
spirit  which  we  doggedly  dub  mental  illness.  And  the 
contradictions  between  science  and  religion  seem  in  many 
ways  as  basic  and  irreconcilable  as  ever.  But  there  is  upon 
the  horizon  a  ray  of  hope  which  comes  from  as  unlikely 
a  direction  and  is  as  altogether  extraordinary  as  any  of 
the  other  developments  which  have  been  considered  in 
ithis  paper. 

i  As  a  result  of  a  succession  of  personal  and  professional 
experiences  whose  narration  will  have  to  wait  for  another 
occasion,  I  have  become  increasingly  convinced,  during 
the  last  ten  or  fifteen  years,  of  the  basic  unsoundness  of 
Freud's  major  premises  and  have,  literally,  read  myself 
back  into  a  position  which  can  be  at  least  loosely  iden- 
tified as  Judeo-Christian.  However,  it  was  only  recently 
that  a  book  came  into  my  hands  which  says,  and  says 
very  clearly  and  confidently,  something  which  is  wanting 
in  most  contemporary  religious  literature  and  preaching. 
I  refer  to  Henry  P.  Van  Dusen's  book,  Spirit,  Son,  and 
Father  (1958).  I  wish  there  were  time  to  develop  the 
reasons  why  I  feel  such  great  excitement  over  this  small 
volume.  Instead  we  must  be  content  with  the  merest 
intimation  of  what  Dr.  Van  Dusen  is  saying.  But  first  let 
me  state,  what  is  of  course  well  known  to  many,  that 
Henry  Pitney  Van  Dusen  is  no  upstart  theologian  or 
fly-by-night  scholar.  He  is  currently  President  of  Union 
flTheological  Seminary,  in  New  York  City,  a  member  of 
numerous  important  boards  and  foundations,  and  the 
author  or  editor  of  some  18  other  thoughtful  books.  And 
Inow  he  comes  forth  with  an  argument  which  is  absolutely 
jrevolutionary  and  yet  is  as  obvious  and  plausible  as  some- 
ithing  one  has  known  all  his  life! 

i  The  gist  of  this  argument  is  that  in  our  interpretation 
^of  the  Christian  Trinity,  we  have  erred  and  confused 
lourselves  by  making  the  order:  God  the  Father,  the  Son, 


124  The  Crisis  in  Psychiatry  and  Religion 

and  the  Holy  Spirit.  Van  Dusen,  paradoxically  and  yet 
shrewdly,  insists  that  the  aspect  of  this  trilogy  which 
has  been  least  emphasized  and  understood  is,  in  reality, 
the  most  important  and  most  immediately  knowable. 
"Something  is  lacking,  and  that  which  is  lacking  is  what 
is  most  important"  (p.  11),  he  says  with  eloquent  sim- 
plicity. Dr.  Van  Dusen  quickly  gains  the  reader's  con- 
fidence and  interest  by  acknowledging  that  he,  along  with 
most  laymen,  had  long  regarded  the  concept  of  the  Holy 
Spirit,  or  Holy  Ghost,  as  extremely  vague  and  at  least 
mildly  repulsive  and  unsavory.  And  yet,  argues  Van 
Dusen,  there  are  strong  historical  and  Christian  grounds 
for  believing  that  it  is  through  the  idea,  indeed  the  ex- 
periencej  of  the  Holy  Spirit  that  all  other  religious  phe- 
nomena and  practices  are  inspired  and  validated.  Then, 
after  citing  a  growing  number  of  other  writers  who  are 
today  also  taking  this  point  of  view,  he  asks:  "Is  not  this 
the  true  message  of  'Christian  Hope*  for  which  our  gen- 
eration longs?"  (p.  11). 3 

With  such  phrases  as  "omnipresence  of  the  Divine  in- 
fluence," "immediately  present  and  supernormally  power- 
ful," "the  moral  consciousness,"  "the  very  principle  of 
personal  religion,"  "the  Transcendent  God  in  action," 
"the  Immanent  God  in  residence"  and  by  reference  to 
the  "inner  light"  of  the  Quakers,  Buchman's  "guidance 
of  the  Spirit,"  and  Kant's  "categorical  imperative  of 
duty,"  Dr.  Van  Dusen  conveys  something  of  the  general 
connotation  which  he  would  have  us  attach  to  the  no- 
tion of  the  Holy  Spirit.  He  properly  notes  that  it  is  at 
this  level  of  thought  and  experience  that  the  "ecumenical 
movement"  on  the  part  of  various  Christian  denomina- 
tions finds  its  soundest  and  most  meaningful  justification 
— ^and  to  this  he  adds,  even  more  broadly: 

Here,  then,  is  the  elemental  meeting-point  of  all  religion 
and  the  proper  starting-point  for  a  comparative  study  of  the 
faiths  of  mankind  (p.  99). 

A  major,  not  to  say  insurmountable,  stumbling  block 
to  the  acceptance  of  Christian  orthodoxy  for  many  con-; 

®In  correspondence,  Dr.  Van  Dusen  has  called  attention  to 
two  other  pertinent  studies.  They  are  Lindsey  Dewar's  The 
Holy  Spirit  in  Modern  Thought  (1959)  and  A.  B.  Gome's 
Human  Spirit  and  Holy  Spirit  (1959). 


Psychotherapy  and  the  Problem  of  Values    125 

temporary  men  and  women  is  the  not  uncommon  insist- 
ence upon  the  uniqueness  and  particularity  of  Christ  and 
of  the  Divine  Revelation  through  Him.  For  the  scientifi- 
cally trained  mind,  order,  regularity,  and  uniformity  per- 
vade the  Universe;  and  suspension  of  natural  law  is  as 
unthinkable  as  is  the  episodic  intervention  of  supernatural 
powers  and  agencies.  Hence,  what  the  scientist  looks  for 
in  the  realm  of  religion,  if  he  looks  for  anything,  is  a  set 
of  principles  and  concepts  which  are  universally  and 
eternally  applicable  and  operative.  In  Van  Dusen's  book, 
what  has  previously  been  seen  as  perhaps  least  promising 
in  the  Holy  Trinity  becomes  actually  the  most  promising 
as  the  basis  of  a  science-religion  reconciliation.  And  the 
significance  and  workability  of  this  rapprochement  be- 
comes especially  pointed  when  one  examines,  specifically, 
the  domain  of  psychopathology. 

VII.   THE   HOLY   SPIRIT,   PSYCHOPATHOLOGY, 
AND   THE   UNCONSCIOUS 

As  is  of  course  well  known,  Freudian  doctrine  holds 
that  the  impulses  which  are  bottled  up  in  the  neurotic's 
unconscious  and  there  provide  the  wellsprings  of  psycho- 
pathology  are  essentially  "evil,"  i.e.,  they  are,  charac- 
teristically, the  impulses  of  hostility  and  lust.^  Granted 
Ithis  premise,  the  objective  of  analytic  therapy  is,  logically 
jenough,  to  release  these  impulses  from  repressive  control 
I — to  let  the  evil  out;  and  this  is  why  therapy  has  been 
[conceived  at  least  metaphorically,  as  the  Devil's  work. 
|In  the  neurotic  individual,  concern  over  virtue  and 
irightness  of  conduct  has,  presumably,  done  its  work 
only  too  well  and  has  to  be  counteracted. 

*This  supposition  is  so  widely  known  that  it  hardly  needs 
documentation;  but  since  reference  has  already  been  made  to 
Freud's  paper,  "A  Neurosis  of  Demoniacal  Possession  in  the 
Seventeenth  Century,"  we  may  note  the  particular  phrasing 
which  Freud  there  gives  to  it:  "What  in  those  days  were 
thought  to  be  evil  spirits  to  us  are  base  and  evil  wishes,  the 
derivatives  of  impulses  which  have  been  rejected  and  repressed. 
In  one  respect  only  do  we  not  subscribe  to  the  explanation  of 
these  phenomena  current  in  mediaeval  times;  we  have  aban- 
doned the  projection  of  them  into  the  outer  world,  attributing 
their  origin  instead  to  the  inner  life  of  the  patient  in  whom 
they  manifest  themselves"  (p.  437). 


126  The  Crisis  in  Psychiatry  and  Religion 

But  now  we  are  having  to  reconsider  all  this,  and  the 
most  likely  alternative  position  is  that  neurosis  is  not  a 
result  of  blocked  and  outraged  biological  forces  but  is 
rather  an  expression  and  consequence  of  "evil"  in  a  very 
different  sense.  The  Freudians,  of  course,  recognize  that 
guilt  is  central  to  neurosis,  but  it  is  always  a  guilt  of  the 
future.  It  is  not  what  the  person  has  done  that  makes 
him  "ill"  but  rather  what  he  wishes  to  do  but  dares  not. 
In  contrast,  the  emerging  alternative — or,  more  ac- 
curately, the  re-emerging  one — is  that  the  so-called  neu- 
rotic is  a  bona  fide  sinner,  that  his  guilt  is  from  the  past 
and  real,  and  that  his  difficulties  arise  not  from  in- 
hibitions but  from  actions  which  are  clearly  proscribed, 
socially  and  morally,  and  which  have  been  kept  carefull} 
concealed,  unconfessed,  and  unredeemed.  Freud's  assump- 
tion, consistent  with  the  position  just  ascribed  to  him. 
was  that  man  is  basically  an  animal,  that  his  most  funda- 
mental nature  is  biologically  ("instinctively")  given,  and 
that  it  is  cultural  and  moral  interference  with  "things  ol 
the  flesh"  which  make  him  emotionally  sick.  From  man} 
quarters  now  comes  reaflSrmation  of  the  view  that  mar 
is  preeminently  a  social  being  and  that  for  him  the  su- 
preme anguish  comes,  not  from  bodily  deprivation  oi 
pain,  but  from  the  rupturing  of  his  sociality  which  we 
broadly  denote  by  the  word  sin  or  alienation.  For  ex 
ample,  Dr.  Karl  Menninger  (1958),  after  reading  ".A 
New  Theory  of  Schizophrenia,"  which  has  already  been 
cited  at  the  outset  of  this  paper,  wrote  to  say: 

I  very  much  liked  the  article.  ...  I  wish  you  would  tell 
[the  author]  that  I  think  it  is  fine  and  that  it  would  be 
even  a  little  better,  in  my  opinion,  if  he  would  not  try  tc 
distinguish  between  schizophrenia  and  other  groups  of  symp 
toms.  Essentially  all  mental  illness  must  be  a  reaction  tc 
some  kind  of  feeling  of  rupture  with  the  social  environmenl 
.  .  .  (personal  communication).^ 

Clear  adumbrations  of  this  point  of  view  can  be  traced 
back  nearly  a  quarter  of  a  century.  In  1936  Anton  T, 
Boisen  published  his  epochal  Exploration  of  the  Innei 
World,  in  which  he  postulated  an  outraged  conscience 
(rather  than  id)  as  the  basis  of  neurosis  and  suggested 

^For  more  extended  statements  of  this  point  of  view,  see, 
among  others,  Anderson  (1959)  and  Jourard  (1958). 


Psychotherapy  and  the  Problem  of  Values    127 

that  there  is  something  potentially  constructive  and 
growth-producing  in  such  a  state  of  mind.  Two  years 
later,  the  erstwhile  Freudian  analyst,  Wilhelm  Stekel, 
published  a  similar  point  of  view  in  a  book  which  did 
not,  however,  become  available  in  English  and  generally 
known  in  this  country  until  1950.  And  in  1947-48  the 
present  writer,  then  unaware  of  the  views  of  either  Boisen 
or  Stekel,  began  the  publication  of  a  series  of  articles 
(see  Mowrer,  1950,  1953)  in  which  repudiation  and  re- 
pression of  conscience,  rather  than  id,  was  likewise 
stressed.  Now,  again  apparently  independently  of  the 
sources  just  cited.  Bishop  Arvid  Runestam,  of  Sweden, 
in  1958,  published  a  book  entitled  Psychoanalysis  and 
Christianity,^  in  which  he  writes: 

The  psychoanalytic  theory  about  repression,  and  the  wide- 
j  spread  neuroses  based  thereon,  .  .  .  give  the  impression  of 
j  a  strong  rancor  on  the  part  of  psychoanalysis  toward  the 
I  needlessly  strict  censure  of  the  life  drive  by  contemporary 
morality.  .  .  .  Psychoanalysis  stands  forth  both  in  theory 
and  practice,  by  and  large,  as  a  potent  promoter  of  the 
right  of  the  spontaneous  instinct-guided  life  to  make  itself 
effective.  It  is  not  as  if  it  means  that  all  morality  is  evil  per 
se.  But  morality  presents  itself  more  as  a  necessary  evil  than 
as  a  positive  good.  Conscience  and  the  "superego"  receive 
the  role  of  operating  purely  negatively  and  restrictively  on 
that  which  alone  appears  to  possess  the  right  to  life,  "the 
life  stream"  itself  (p.  37). 

However,  there  are  two  objections  to  the  psychoanalytical 
doctrine  of  repression.  These,  by  the  way,  finally  unite  into 
one.  With  reference  to  the  notion  that  it  is  primarily  the 
sex  instinct  and  the  emotional  energy  it  involves,  which  the 
analysts  imply  have  been  unduly  restrained,  one  may  ask: 
As  one  looks  at  the  present  situation  and  the  contemporary 
moral  condition,  is  there  anything  that  seems  to  indicate 
that  this  drive  has  really  suffered  such  terrible  damage?  On 
the  contrary,  is  it  not  at  least  plausible  that  the  repression 
leading  to  neurosis  is  caused  by  the  repressing  of  other, 
usually  considered  higher,  instincts?  Have  the  religious  and 
moral  instincts — or,  if  we  do  not  like  to  call  them  "in- 
stincts," those  factual,  inherited  or  acquired  religious  and 
moral  forces,  emotions,  imaginings,  needs — ^been  treated  more 
mercifully  by  contemporary  ruling  powers  than  the  lower 

•This  book  is  a  revision  and  translation  of  a  much  earlier 
Swedish  edition,  which  appeared  in  1932.  For  its  day,  the 
wiginal  version  was  prophetic  indeed! 


'   128  The  Crisis  in  Psychiatry  and  Religion 

instincts  have?  May  it  not  be  that  these  higher  instincts, 
needs,  and  forces,  rehgious  and  moral,  have  suflfered  damage, 
and  that  repression  and  neuroses  have  their  bases  just  in 
this?  (pp.  41-42). 

Would  it  be  too  large  a  leap  to  equate  or  at  least  liken 
The  Unconscious,  as  reinterpreted  by  the  writers  just 
cited,  to  the  Holy  Spirit,  as  Van  Dusen  conceives  of  it? 
If  such  an  identification  (or  even  a  partial  one)  can  be 
granted,  a  new  and  powerful  basis  is  at  hand  for  the  in- 
tegration of  psychology  and  religion.  Here  is  a  force  in 
human  personality  and  in  the  Universe  whose  manifesta- 
tion and  functioning  can  be  scientifically  studied  and 
which,  at  the  same  time  (according  to  Van  Dusen;  see 
also  Boisen's  reference  to  ''that  social  something  called 
God")  is  the  heart  and  essence  of  religious  experience. 

How  very  different  this  conception  is  from  the  classical 
Freudian  one  is  indicated  by  the  fact  that  where  Freud 
expected  to  find — and,  with  the  aid  of  "diabolical" 
strategies,  release — Evil,  we  now  believe  the  Holy  Spirit 
to  reside!  This  changing  view  of  the  unconscious  has 
been  more  fully  developed  elsewhere  [Chapters  2  and 
8]  and  cannot  be  elaborated  here.  But  enough  has  al- 
ready been  said  to  show  how  revolutionary  all  this  is  from 
a  theoretical  standpoint;  and  it  is  not  at  all  inconceivable 
that  corresponding  reforms  will  follow  in  practice,  in 
both  religious  and  psychological  circles.  Freud,  as  we  havei 
seen,  did  not  take  guilt  seriously;  it  was  instead  in- 
stinctual deprivation  and  frustration  that  concerned  and 
interested  him.  One  is  little  short  of  dazzled  by  the  pos- 
sibilities that  seem  to  lie  before  us  if,  for  a  change,  w€ 
were  to  take  guilt  seriously  and  at  the  same  time  workec 
out  ways  of  dealing  with  it  which  are  more  realistic  anc 
effective  than  those  which  have  characterized  Protestant 
ism  and  even  Catholicism  in  its  least  vital  forms. 

In  his  book,  Spirity  Son  and  Father^  Van  Dusen  cite; 
a  "bold  prophecy"  made  some  years  ago  by  F.  D.  Mau 
rice  to  this  effect: 

"I  cannot  but  think  that  the  reformation  in  our  day 
which  I  expect  to  be  more  deep  and  searching  than  that  o 
the  sixteenth  century,  will  turn  upon  the  Spirit's  preseno 
and  life,  as  that  did  upon  the  Justification  by  the  Son' 
(p.  15). 


Psychotherapy  and  the  Problem  of  Values    129 
And  a  few  pages  later  Van  Dusen  himself  remarks: 

Time  and  again,  the  Holy  Spirit  has  dropped  from  the 
center  of  attention  because  it  has  been  lost  from  the  heart 
of  experience;  theological  crystallization  and  controversy  have 
preoccupied  men's  minds  reliance  upon  creed  and  cult,  upon 
form  and  structure,  has  displaced  expectation  of  new  dis- 
closures, sometimes  with  determinative  influence  and  often 
with  baneful  effect  upon  man's  conception  of  the  Holy 
Spirit.  Always,  perhaps  at  long  last,  the  Holy  Spirit  has  re- 
turned, first  as  an  experience  and  secondarily  as  a  doctrine, 
to  revive  men's  souls  and  banish  their  defeat  and  despair, 
and  then  to  reanimate  the  dead  skeletons  of  ecclesiastical 
organization  and  redeem  the  dry  rot  of  dogma  (pp.  27-28). 

If  psychology  and  religion  can  join  forces,  both  con- 
ceptually and  practically,  it  is  not  beyond  imagining  that 
we  shall  yet  live  to  see  men's  souls  revived  and  their  de- 
feat and  despair  vanquished. 


10 

Psychology,  Theology, 
and  the  Social  Self  * 

Certainly  the  commonest  and,  in  some  ways,  the  most 
serious  objection  to  the  notion  that  sin  or  real  guilt  is 
the  root  cause  of  personality  disturbances  is  that  such  a 
state  or  condition  cannot  be  objectively,  scientifically 
defined.  What  are  the  criteria,  it  is  asked,  according  to 
which  we  decide  what  is  good  or  bad,  virtue  or  evil?  And 
by  implication,  if  a  phenomenon  can't  be  precisely,  opera- 
tionally defined,  it  doesnt  exist.  Many  of  us  have  very 
much  wanted  to  get  rid  of  moral  values,  to  believe  that 
reality  is  ethically  neutral,  and  that  experience  or  action 
is  good  or  bad  only  insofar  as  it  is  followed  by  pleasure 
(lust)  or  displeasure  (unlust).  But  gradually  we  are  re- 
discovering that  there  is  more  to  human  existence  than 
mere  biology  and  that  social  systems  {and,  indeed,  per- 
sonality itself)  cannot  exist  without  prescribed  and  pro- 
scribed patterns  of  feeling  and  conduct  (cf.  Chapter  3 ) . 

After  some  preliminary  considerations,  we  come  to 
grips  in  this  chapter  with  at  least  one  way  of  thinking 
about  the  problem  of  ethics,  operationally  and  objectively, 
and  of  dispelling  some  of  the  wishful  doubting  in 
which  we  have  previously  engaged.  Here  we  also  touch 
upon  the  currently  much-debated  issue  of  conformity  and 
nonconformity.  The  charge  that  values  and  ethics  are  un- 
scientific concepts  (and  therefore  not  to  be  taken  se- 
riously) seems  to  be  giving  way  to  the  view  that  no 
conception  of  personality  and  of  society  can  be  truly 
scientific  which  ignores  these  considerations. 


*  The  third  of  three  lectures,  on  the  general  subject  of 
"Psychoanalysis  and  the  Judeo-Christian  Ethic,"  presented 
February  23-25,  1960,  under  the  auspices  of  the  E.  T.  Earl 
Lectureship  Foundation  and  the  Pastoral  Conference  of  the 
Pacific  School  of  Religion,  Berkeley,  California. 

130 


Psychology,  Theology,  and  Socl^  Self  131 

In  the  first  lecture  in  this  series,  I  tried  to  show  that 
man  is  pre-eminently  a  social  creature — or,  in  theological 
phrase,  a  Child  of  God — and  that  his  greatest  anguish 
comes,  not  from  bodily  discomfort  or  instinctual  frustra- 
tion, but  from  violation  of  his  sociality,  from  estrange- 
ment, from  unacknowledged  and  unatoned  real  guilt. 
And  in  the  second  lecture  we  examined  some  of  the  his- 
torical reasons — or  should  we  say,  vagaries? — which 
caused  us  to  abandon  this  ancient  and  empirically-based 
position  and  drift  into  the  style  of  life  epitomized  by  the 
term  'Treudianism."  It  is  now  clear  that,  despite  his 
explicit  disavowal  of  philosophical  intent  and  his  insist- 
ence that  he  was  merely  a  scientist  and  physician,  Sig- 
mund  Freud  actually  conceived  of  himself  as  having  a 
messianic  mission  in  the  world  and  was  aiming  at  nothing 
less  than  a  cultural  and  moral  revolution. 

But  there  are  now  widespread  and  growing  indications 
that  the  premises  upon  which  this  reformation  was  to  be 
founded  are  unsound  and  that  Freud's  aims  and  motiva- 
tions were  not  messianic  but  demonic.  We  have  good 
reason  to  believe  that  psychopathology,  instead  of  stem- 
ming from  unexpressed  sex  and  hostility,  comes  rather 
from  an  outraged  conscience  and  violated  sense  of  human 
decency  and  responsibility.  This  radically  revised  percep- 
tion of  the  basis  and  nature  of  mental  illness  suggests  an 
affinity  with  both  classical  and  contemporary  conceptions 
of  the  Holy  Spirit  and  points  the  way  to  a  new  synthesis 
of  religion  and  contemporary  psychological  and  social 
science. 

How,  then,  shall  we  proceed  in  this,  the  third  and  final 
lecture?  Since  the  first  two  lectures  were  written  some 
months  ago,  I  propose,  first  of  all,  that  we  briefly  ex- 
amine and  evaluate  inten^ening  developments  and  then 
decide  upon  the  direction  of  our  ensuing  discussion. 

I.   FURTHER   SIGNS   OF   THE   COLLAPSE 
OF   FREUDIANISM 

Although  it  is  not  particularly  recent,  I  want  to  begin 
by  citing  an  invited  address  delivered  to  the  American 
Psychiatric  Association  in  1956,  by  Dr.  Percival  Bailey. 
Dr.  Bailey  is  Director  of  the  Illinois  State  Psychopathic 


132  The  Crisis  in  Psychiatry  and  Religion 

Institute;  and  his  address,  which  has  just  come  to  my 
attention,  is  entitled  "The  Great  Psychiatric  Revolution." 
Here  Dr.  Bailey  reluctantly  expresses  the  opinion  that 
the  so-called  "psychiatric  revolution"  which  was  produced 
by  Freudian  psychoanalysis  has  come  to  naught.  He  says: 

The  great  revolution  in  psychiatry  has  solved  few  problems. 
...  I  understand  now  why,  in  the  last  years,  I  have  a! 
recurrent  dream  that  I  am  wandering  through  a  dense  path- 
less forest  but  never  arrive  anywhere  before  I  finally  wake. 
Lately  I  have  another  recurrent  dream:  A  vine,  seeking  in 
vain  a  support  on  which  to  climb  to  higher  things,  twines 
around  its  own  base  (p.  402). 

More  specifically,  Dr.  Bailey  says: 

It  has  become  a  habit,  in  beginning  a  psychiatric  lecture^ 
to  pay  tribute  to  Freud's  genius.  Thus  Montague  (1955), 
in  his  dinner  address  to  this  Association,  remarked:  "This 
general  [pessimistic]  viewpoint  has  received  what  is  perhapsj 
its  most  striking  reinforcement  from  a  source  which  undoubt-1 
edly  represents  the  most  insightful  contribution  to  our  under- 
standing of  human  nature  in  the  history  of  humanity.  I 
refer  to  the  psychoanalytic  theories  of  Sigmund  Freud,"  He 
[Montague]  then  proceeds  to  demolish  the  viewpoint.  .This 
is  an  old  procedure;  Freud  (Wortis,  1954)  complained  bit- 
I  terly  of  it.  Still,  his  teachings  continue  to  arise  like  a  phoenix 
from  its  ashes.  Lately  a  psychologist  was  overheard  at  the 
Chicago  State  Hospital  expounding  for  the  delectation  of 
the  affiliate  nursing  students,  on  whom  we  spend  thousands 
of  dollars  every  year  to  bring  them  to  our  hospitals,  the 
discredited  theory  of  infantile  parental  incest  in  all  its  pristine 
naivete.  When  one  remembers  how  the  teaching  of  Franz 
Josef  Gall  still  colors  all  our  neurological  thinking  one 
wonders  how  long  the  hoary  errors  of  Freud  will  continue 
to  plague  psychiatry  (p.  395). 

And  Dr.  Gamilla  Anderson,  staff  psychiatrist  at  Salem 
(Oregon)  State  Hospital  (and  author  of  a  1957  book 
entitled,  Beyond  Freud)  has,  in  like  vein,  remarked  in 
a  recent  letter:  'T  cannot  help  but  feel  that  the  equation 
of  Freud  with  the  devil  [in  the  second  lecture  in  this 
series]  is  clinically  sound  and  also  socially.  I  believe  that 
we  shall  not  soon  overcome  his  pernicious  influence." 

Writing  in  the  Reader's  Digest  for  January,  1960, 
Dr.  H.  J.  Eysenck,  Director  of  the  Psychological  Labo- 
ratories of  the  Institute  of  Psychiatry  at  the  University. 


Psychology,  Theology,  and  Soclu.  Self  133 

of  London,  in  an  article  entitled,  "What's  the  Truth 
about  Psychoanalysis?"  points  out  that  psychoanalysis  is 
no  more  effective  in  the  cure  of  personality  disorders  than 
the  mere  passage  of  an  equivalent  period  of  time  would 
be.  Like  Dr.  Bailey,  Eysenck  also  refers  to  the  revolution 
which  analytic  theory  and  practice  supposedly  brought 
about  in  psychiatry  and  then  observes  laconically: 

The  success  of  the  Freudian  revolution  seemed  complete. 
Only  one  thing  went  wrong:  the  patients  did  not  get  any 
better  (p.  40).' 

Many  of  you  will  also  have  seen  the  21 -page  spread  in 
Look  Magazine  (for  February  2,  1960)  entitled  *Tsy- 
chiatry — The  Troubled  Science."  And  particularly  sig- 
nificant was  the  appearance,  last  year,  of  a  book  by  Pro- 
fessor Richard  LaPiere,  of  the  Department  of  Sociology 
of  Stanford  University,  entitled  The  Freudian  Ethic.  The 
Saturday  Review y  for  August  1,  1959,  ran  a  six-page 
Isynopsis  of  this  book,  entitled  'The  Apathetic  Ethic." 
There  are  many  arresting  and  quotable  passages  in  this 
synopsis  (as  in  the  book  itself),  but  the  following  catches 
the  general  tenor  and  flavor: 

As  a  code  of  conduct  the  Freudian  ethic,  as  it  will  be 
termed  hereafter,  is  entirely  negative.  It  is  composed  of 
sentiments  and  attitudes  regarding  man's  capabilities  which, 
if  literally  applied,  would  keep  him  from  attempting  any- 
thing positive,  to  say  nothing  of  attempting  to  devise  any- 
thing new.  Some  appreciation  of  this  state  of  mind  can, 
perhaps,  be  gained  from  the  terminology  used  by  those  who 
subscribe  to  it.  In  their  discourse  there  is  recurrent  reference 
to  guilt  feelings,  personal  insecurity,  instability,  frustration, 
trauma,  and  "tensions."  Such  terms  are  used  in  reference  not 
only  to  recognizably  abnormal  individuals  but  to  everyone. 
Still  more  revealing  is  the  total  absence  in  the  Freudian 

^Analysts  were  always  frank  to  admit  their  lack  of  success 
ivith  paranoid  personalities  and  the  addictions,  including  alco- 
lolism.  What  conditions  did  this  leave  in  which  to  achieve 
heir  so-called  "triumphs"?  Basically,  anxiety  states  and  depres- 
jions,  which  tend  to  be  naturally  self-limiting  and  transitory 
(though  often  recurrent).  Thus,  if  a  person  is  in  analysis  two 
Dr  three  years,  it  is  not  unlikely  that  he  will  find  himself  feeling 
1  good  deal  better.  But  there  is  serious  question  as  to  how 
nuch  credit  analysis  can  take  for  it.  The  chances  are  the  person 
jvould  have  improved  anyway.  (Cf.  Freud,  1937). 


134  The  Crisis  in  Psyciiutry  and  Religion 

discourse  of  such  terms  as  self-confidence,  personal  integrity, 
self-reliance,  responsibility,  or  such  an  earthy  term  as  "guts" 
(p.  40). 

Also  pertinent  to  our  purposes  is  the  following  passage: 

It  is  the  thesis  of  this  study  that  many  of  the  changes 
that  have  been  of  late  years  occurring  in  our  society  are 
malfunctional  and  that  they  will,  if  they  continue  uncor- 
rected, constitute  our  unrecognized  road  to  disaster.  These 
changes  are  being  wrought  by  men  of  many  kinds  and 
various  functions — by  psychiatrists  and  child  psychologists  of 
the  Freudian  persuasion,  by  permissive  parents  and  progres- 
sive teachers,  by  welfare  workers  and  impressionable  judges, 
by  managers  of  business  and  industry  and  leaders  of  labor 
and  academic  life,  and  by  politicians  and  political  adminis- 
trators of  many  sorts.  Moreover,  they  are  being  demanded 
or  welcomed,  or  at  least  passively  accepted,  by  almost  every- 
one (p.  44).^ 

Here  I  would  suggest  one  or  two  not  unimportant 
emendations  of  Professor  LaPiere's  statement.  By  some; 
odd  coincidence,  he  fails  to  mention  that  professional 
group  which,  just  at  present,  is  probably  doing  more  than 
any  other  to  perpetuate  what  he  calls  the  Freudian  Ethic. 
At  a  time  when  psychiatrists  and  psychologists  are  rather 
generally  abandoning  psychoanalytic  theory  and  practice, 
ministers  and  theologians  are,  as  a  group,  subtly  or 
stridently  advocating  it.  I  realize,  of  course,  that  there' 
are  many  clergymen  who  are  outstanding  exceptions  to 
this  observation;  but  as  a  profession,  theologians  are  at 
the  moment,  it  seems,  more  heavily  under  the  sway  of 
Freudian  ideology  than  any  other  comparable  group,  in- 
cluding psychologists  and,  quite  possibly,  even  psy- 
chiatrists [Chapters  4,  6,  and  9]. 

The  churches  and  the  seminaries  are,  I  believe,  actually 
in  process  of  house  cleaning  and  will  presently  recover 
from  this  aberration.  Recently,  I  had  the  privilege  of 
hearing  a  tape  recording  of  the  keynote  address  delivered, 
in  August  of  1959,  by  Harvey  Cox  at  the  opening  session 
of  the  annual  meeting  of  The  National  Student  Councils 

^  See  also  a  series  of  three  lectures  entitled  "Rake's  Progress 
in  Religion"  delivered  by  Dean  R.  E.  Fitch  during  the  1960 
Pastoral  Conference  of  the  Pacific  School  of  Religion,  Berkeley, 
California. 


Psychology,  Theology,  and  Social  Self  135 

of  the  YMCA  and  YWCA.  Allow  me  to  quote  an  ex- 
cerpt from  this  tape.  Having  cited  the  Columbia  sociolo- 
gist, C.  Wright  Mills,  on  the  distinction  between  "trou- 
bles" and  "issues,"  to  which  we  shall  return  presently. 
Cox  says: 

As  a  student  YM  and  YW,  I  think  we  have  been  smitten 

by  a  hasty  love  affair  with  depth  psychology,  with  troubles, 

I    with  symptoms.  Think  of  all  the  ink  spilled  over  discovering 

I    myself,  of  unmasking  and  revealing  each  other's  true  and 

J    undisguised  egos.  I  think  we've  had  about  enough  of   the 

Who-am-I?  bit.  Think  of  the  countless  programs  we've  had 

trying  to   answer  this   somewhat  misleading  question.  And 

then  think  just  how  far  this  is  from  Biblical  radicalism. 

I  A  member  of  the  Salvation  Army  also  recently  gave  me 
1  quite  remarkable  piece  of  information.  The  "Army,"  it 
ippears,  keeps  "statistics."  And  what  do  they  show?  Some 
/ears  ago  this  organization,  along  with  religious  denomi- 
lations  generally,  decided  that  it  was  losing  out  on  a 
jood  thing  and  that  it,  too,  should  go  in  for  the  "depth 
psychology"  alluded  to  by  Mr.  Cox.  And  what  is  the 
esult?  A  steady  decline  in  the  effectiveness  of  this  organi- 
sation in  salvaging  lost,  disorganized  men  and  women.  A 
iirective  has  therefore  gone  out  from  the  Commissioner, 
it  the  Salvation  Army's  Headquarters  in  Chicago,  to  its 
ichools  and  training  centers  to  abandon  the  "depth"  ap- 
)roach  and  revert  to  its  more  traditional  methods.^ 

There  are,  I  believe,  many  similar  trends  in  our  more 
;onventional  religious  denominations.  But  a  confusing 
lomplication  exists  here,  namely,  the  unprecedented  re- 
lent  upsurge  in  church  attendance  and  membership.  I 
)ersonally  do  not  doubt  that  this  "return  to  religion"  is 
omewhat  related  to  the  renewed  interest  on  the  part  of 
ilergymen  in  personal  problems — to  the  resurgence,  that 
s,  of  personal  counseling,  and  of  the  impact  of  this  inter- 
;st  upon  the  pulpit  ministry.  But  I  would  ask  you  also 
0  consider  the  alternative  interpretation  offered  by 
larvey  Cox.  He  says: 

For  myself,  the  return  to  religion  is  only  evidence  on  the 
wrong  side.  I  think  most  of  it  is  simply  a  speed-up  in  the 

'^Cf.  God  at  the  Scrap  Heaps  by  H.  F.  Milans  (1945)  and 
I.  L.  Brengle's  Helps  to  Holiness  (1948). 


136  The  Crisis  in  Psychiatry  and  Religion 

anxious  effort  to  cling  to  a  19th-century  style  of  life  which! 
has  on  it  the  mark  of  futility. 

And  the  fact  that  a  person  of  my  own  persuasions  has 
been  invited  to  give  these  lectures,  here  at  the  Pacific 
School  of  Religion  and  the  38th  Annual  Pastoral  Confer- 
ence, this  year  is,  it  would  seem,  yet  another  indication  of 
the  willingness  of  churchmen  at  least  to  entertain  the  pos- 
sibility that  they  have  been,  literally,  mis-taken  in  this 
area  and  need  to  reconsider  their  own  great  traditions; 
and  indigenous  potentialities.  This  is  not,  by  any  means,- 
to  say  that  all  we  need  is  simply  to  return  to  pre-Freudian 
theology  and  doctrine.  As  I  tried  to  indicate  in  the  second 
lecture,  psychoanalysis  came  as  a  judgment  upon  19th- 
century  religious  ideology  and  practice.  But  we  must  not 
take  the  judgment,  the  indictment,  the  curse  itself  as  the 
cure-^which,  as  I  see  it,  is  substantially  what  many  thci 
ologians  have  been  disposed  to  do. 

In  short,  what  I  have  just  suggested  is  that  on-going 
developments  indicate,  with  every  increasing  clarity,  the 
steady  deterioration  of  what  Professor  LaPiere  has  aptly 
called  the  Freudian  Ethic  and  that  we  have  no  choice 
but  to  get  about  the  business,  at  once,  of  finding  some- 
thing more  suitable  and  substantial  to  take  its  place. 
Conant's  dictum  that,  in  science,  a  theory  is  never  over- 
thrown by  contradictory  facts,  only  by  another,  better 
theory,  is  well  known.  Surely  empirical  evidence  tending 
to  refute  Freud's  basic  assumptions  has  been  lying  pro- 
fusely about  all  the  time.  But  19th-century  theology  had 
manoeuvred  itself  into  so  many  metaphysical  absurdities 
that  when  Freud  came  along  with  his  brazen  and  bril- 
liantly formulated  heresies,  the  Church  was  no  match  for 
him.  Now  we  see  Freud  in  a  truer  light,  not  as  Messiah 
but  as  Deceiver,  and  the  Church  will  continue  to  pay 
homage  to  him  at  its  peril. 

II.  WHAT,  THEN,  SHALL  WE  DO  TO  BE  SAVED? 

For  several  years  now,  during  the  Summer  Session  at 
the  University  of  Illinois,  I  have  taught  a  course  in  our 
College  of  Education  entitled  ''Mental  Hygiene  foi 
Teachers";  and  when  we  get  about  half  or  two-thirds 
through  this  course   (which  covers  much  of  the  same 


Psychology,  Theology,  and  Social  Self  137 

ground  we  have  explored  in  these  lectures,  although  more 
systematically),  students  regularly  begin  asking:  So  what 
can  we  do  about  the  situation?  As  the  diagnosis  of  our 
predicament  becomes  clear,  they  begin  asking  about  the 
prognosis,  the  prescription  for  corrective  action.  In  the 
past  I  have  been  compelled  to  say  that  I  did  not  know 
the  answer.  But  the  situation  is,  I  believe,  gradually 
becoming  clarified.  As  I  have  already  indicated  [Chapter 
i7],  it  would  appear  that  the  Church  must  become  con- 
cerned, in  a  new  and  more  vital  way,  with  the  problem  of 
mental  illness.  No  longer  should  it  take  a  position  of  sub- 
servience to  a  profession  which,  by  its  own  admission, 
has  failed  to  solve  this  problem  [see,  for  example.  Chap- 
ter 4];  instead,  it  must  approach  the  problem  indig- 
enously, that  is,  in  terms  of  religion's  own  great  insights 
and  authority.  And  if  its  present  precepts  and  principles 
are  not  sufficient  to  this  task,  they  must  be  modified  and 
revised  until  they  are. 

As  part  of  such  a  program,  it  seems  clear  that  we  are 
moving  toward  a  reinstitution  of  regular  confession  in 
the  various  Protestant  denominations.  'Tastoral  counsel- 
ing" is  merely  a  euphemism  for  a  voluntary,  nonprescrip- 
tive  form  of  confession;  and  this,  if  handled  rightly,  can 
unquestionably  be  helpful — far  more  so,  I  believe,  than  it 
ordinarily  is  at  present.  But  we  also  need  to  move  on 
from  the  prevailing  medical  notion  that  one  goes  for 
"help"  or  "treatment"  only  after  one  is  in  trouble,  i.e., 
already  "sick,"  to  an  active  program  of  prevention;  and 
it  is  here  that  the  obligatory  aspect  of  confession  takes 
on  special  urgency.  There  is  at  present  considerable 
receptivity  to  this  idea;  and  I  should  not  be  surprised 
to  see  it  effectively  implemented  in  the  near  future, 
particularly  in  Lutheran  and  Episcopal  circles. 

I  realize,  of  course,  that  these  statements,  without  the 
full  context  from  which  they  derive,  may  sound  arbitrary 
and,  to  some,  perhaps  even  heretical;  but  in  the  Nyvall 
Lectures  this  spring,  I  hope  to  develop  this  train  of 
'thought  in  a  fully  documented  and  more  persuasive  man- 
ner [see  Chapters  11  and  12]. 

What  remains,  then,  for  us  to  consider  this  evening? 

I  believe  that  in  order  to  round  out  the  argument  and 

ijanalysis  launched  in  the  first  two  lectures  in  this  series 

iwQ  should  employ  the  remainder  of  our  time  together 


138  The  Crisis  in  Psychiatry  and  Religion 

along  the  following  lines.  For  some  decades  now,  we  have 
been  in  the  habit,  whenever  a  person  was  deeply  troubled 
and  disturbed,  of  saying:  He  (or  she)  "needs  therapy." 
At  last  we  are  waking  up  to  the  fact  that  the  "therapy"! 
we  have  been  so  blandly  prescribing  for  others  (and  our-i 
selves)  is  fundamentally  worthless — a  "therapy"  which 
does  not  heal  and  which,  as  a  general  social  philosophy 
and  guide  to  life,  is  downright  pernicious.  Now  we  are 
beginning  to  realize  that  the  commodity  which  practi- 
tioners of  this  dubious  art  have  been  selling  for  $25  to 
$50  an  hour,  or  whatever  the  market  will  bear,  is  a  snare 
and  delusion  and  that  a  radically  different  approach  is 
called  for.  Now,  instead  of  talking  just  about  "sick"  in- 
dividuals, we  are  beginning  to  talk  about  a  sick  society; 
and  I  submit  that  an  important  aspect  of  this  generalized 
sickness  is  the  very  fact  that  we  speak  of  our  individual 
and  collective  diflSculties  as  "sickness,"  rather  than  as  sin 
or  evil.  As  Professor  LaPiere  has  pointed  out,  sickness  is 
a  stultifying  and  enervating  concept;  by  contrast,  there  is 
something  salutory  and  vitalizing  about  the  notion  of  evil. 
It  gives  us,  by  implied  antithesis,  a  new  vision  of  the  good 
and  something  to  work  for,  something  positive  and  sub- 
stantial on  which  Dr.  Bailey's  "vine"  can  cling  and  grow. 
In  short,  then,  it  seems  that  what  we  have  been  calling 
"therapy"  itself  needs  "therapy,"  and  when  this  becomes 
the  case,  the  nature  of  the  problem  shifts  into  a  whole 
new  register,  a  different  universe  of  discourse.  Some  years 
ago,  Rollo  May  (1953)  pointed  out  that  whenever  there 
is  widespread  need  for  individual  psychotherapy  in  a. 
society,  there  is  an  institutional  and  structural  crisis  in 
that  society.  And  Harvey  Cox,  in  the  address  already 
alluded  to,  develops  this  thought  even  more  explicitly. 
Having  cited  C.  Wright  Mills  for  the  distinction  between 
troubles  and  issues,  he  says: 

Troubles  are  personal,  singular,  and  individual.  Issues  are 
structural,  general,  pervasive.  When  one  man  can't  get  a 
job,  that's  trouble;  when  six  million  men  are  out  of  work, 
that's  an  issue.  When  an  occasional  couple  can't  make  a 
marriage  work,  that's  trouble — maybe  very  serious  trouble. 
When  the  divorce  rate  climbs  to  a  failure  of  one  out  of 
three  marriages,  that's  an  issue. 

Now  I  submit  that  in  the  psychiatry-religion  area,  we 
are  today  confronted,  not  just  by  troubles — i.e.,  individ- 


Psychology,  Theology,  and  Social  Self  139 

ual  failures  to  function  within  an  essentially  sound  in- 
stitutional and  ideological  framework — but  by  issues, 
deep,  pervasive  questions  of  such  urgency  that,  as  Pro- 
fessor LaPiere  suggests,  our  collective  as  well  as  individual 
survival  may  well  depend  upon  the  way  in  which  we  re- 
spond to  them.  Therefore,  in  the  time  that  remains  this 
evening,  I  propose  that  we  continue  our  quest  for  clarifi- 
cation of  these  issues,  on  the  assumption  that  this  is  a 
;necessary  prelude  to,  or  at  least  concomitant  of,  practical 
reconstruction  and  reform. 

In  thus  stressing  the  importance  of  intellectual  analy- 
|sis,  I  realize  the  danger  of  being  taken  in  something  of 
a  contradiction.  On  other  occasions  [see,  for  example. 
Chapter  3],  I  have  argued  against  the  therapeutic  impor- 
itance  of  "insight"  and  sheer  theoretical  ''understand- 
ing" in  favor  of  concrete  modifications  of  behavior.  In- 
formally, I  have  often  cited  an  aphorism  by  E.  Stanley 
Jones  to  the  effect  that  it  is  easier  to  act  yourself  into  a 
new  way  of  thinking  than  to  think  yourself  into  a  new 
way  of  acting.  And  Lloyd  Douglas  commonly  has  char- 
acters in  his  novels  admonish  others  to  seek  the  ''under- 
standing" that  comes,  not  from  mere  thought  and  talk, 
but  from  actually  trying  out  another  life  style  and  inter- 
personal strategy.  "Make  an  investment,  perform  an  ex- 
periment," is  Douglas'  terse  way  of  putting  it. 

Now  Jones,  and  Douglas,  and  Cox  are  not,  I  believe,  in 
the  least  disparaging  the  normal  interplay  of  thought  and 
action.  Rather  are  they  rebelling  against  the  interminable 
rumination  and  "free  association"  that  goes  on  in  psy- 
fchoanalysis  and  related  procedures,  with  an  explicit  ban 
on  experimentation  with  new  types  of  action,  new  pat- 
terns of  conduct  and  life  style.  During  a  classical  Freud- 
ian analysis,  the  patient  is  expressly  forbidden  to  make 
any  major  decisions  or  changes,  in  his  life,  on  the 
grounds  that  while  the  treatment  is  in  process  he  will  not 
be  competent  to  do  so  and  might  make  serious  mistakes. 
The  patient,  while  in  treatment,  may  be  encouraged  to 
"reality  test"  in  the  matter  of  greater  expression  of  sex 
and  aggression;  but  anything  so  radical  as  turning  over  a 
new  leaf  and  trying  to  put  one's  moral  house  in  order  is 
strenuously  discouraged. 

One  of  the  many  paradoxes  that  have  beset  psycho- 
analysis is  that  while  maintaining  the  essential  irrational- 


140  The  Crisis  in  Psychiatry  and  Religion 

ity  of  man,  it  put  its  supreme  trust  in  verbal  operations 
and  neglected  the  power  of  what  G.  H.  Mead  has  called 
the  concrete  social  act.  Small  wonder,  therefore,  that 
analysis  often  stretches  out  interminably  and  in  the  end 
— if  there  is  an  end — leaves  the  analysand  in  an  intel- 
lectual and  emotional  morass.  Somewhat  parenthetically, 
yet  with  all  seriousness,  I  want  to  suggest  that  the  com- 
fortable and  well-to-do  classes  in  our  society  have  been 
trying  to  buy  forms  of  personal  redemption  not  nearly  as 
potent  as  those  cures  or  "therapies"  to  which  the  poor 
have  always  been  limited.  I  am  thinking  not  only  of  Al- 
coholics Anonymous,  but  also  of  the  dramatic  transforma- 
tions of  men  and  women  which  the  Salvation  Army  fre- 
quently achieves;  and  there  is  even  evidence — see  for 
example  Boisen's  book,  Churches  of  Crisis  and  Custom 
— that  certain  practices  in  the  so-called  sect  churches  are 
drastic  but  potently  restorative.*  In  other  words,  I  am 
suggesting  that  the  time  has  come  when  we  must  recog- 
nize that,  in  our  efforts  to  purchase  a  form  of  salvation 
which  is  supposedly  better  and  less  crude  than  anything 
which  the  poor  can  afford,  we  have  been,  in  effect,  wast- 
ing our  money.  There  is  no  clear  evidence  of  the  efficacy 
of  professional  psychotherapy — certainly  nothing  to  com- 
pare with  the  manifest  transformations  achieved  by  AA 
and  the  Salvation  Army;  and  I  have  often  wondered  if, 
when  we  find  we  ''need  therapy,"  we  would  not  be  better 
off  if,  instead  of  getting  a  so-called  therapist  and  paying 
him  a  generous  fee,  we  gave  the  same  amount  of  money 
each  week  to  some  really  good  cause. 

A  Swedish  psychoanalyst,  Dr.  Nils  Haak,  who  has  written 
extensively  on  the  importance  of  high  fees,  says  the  belief 

*  I  am  thinking,  for  example,  of  a  story  which  a  minister 
of  one  of  the  so-called  sect  or  "fringe"  denominations  told 
me  recently  of  the  way  in  which  confession  before  his  congre- 
gation, demanded  by  the  authorities  of  his  group  when  he  was 
apprehended  in  homosexual  practices,  cured  him  of  this  per- 
version, then  and  there,  and  laid  the  basis  for  successful  mar- 
riage and  parenthood.  In  secular  psychotherapy,  by  contrast, 
we  are  ordinarily  content  with  much  smaller  changes  or  "move- 1 
ment."  Some  years  ago  a  dramatic  critic,  in  commenting  on  the 
performance  of  Katharine  Hepburn  in  a  play,  remarked  that 
she  had  run  the  emotional  gamut  "from  A  to  B."  A  similar 
characterization  is  in  order  with  respect  to  the  results  of  psycho- 
therapy. 


Psychology,  Theology,  and  Social  Self  141 

that  what  is  cheap  is  of  httle  value  is  deeply  rooted  in  the 
human  mind.  He  argues  that  by  demanding  a  high  fee,  the 
analyst  appears  to  the  patient  as  a  forthright  individual  who 
dares  to  be  honest  about  money.  This  makes  the  analyst  a 
fine  person  for  the  patient  to  emulate.  A  high  fee,  Haak 
says,  also  prevents  the  patient  from  feeling  infantile  and 
becoming   dependent    upon    his    analyst.    For    the   neurotic 
patient  who  likes  to  hurt  himself,  the  making  of  large  pay- 
ments to  the  analyst,  according  to  the  Swedish  doctor,  is 
an  excellent  outlet  for  neurotic  feelings.  If  the  analyst  were 
to  allow  the  patient  to  pay  only  a  small  fee,  it  might  give 
him  a  humihating  sense  of  gratitude  that  would  interfere 
with  his  therapy.  There  is  also  the  attitude  of  the  analyst 
j     to  consider,  according  to  Dr.  Haak.   If  he  charges  a  low 
I  -  fee,  the  analyst  may  begin  to  doubt  his  own  motives  for 
doing  so.  He  might  wonder  whether  he  is  in  love  with  his 
patient,  or  if  he  really  hates  the  patient  and  is  trying  to 
I     cover  up  by  being  kind.  This  sort  of  thing  can  seriously 
I     interfere  with  the  analyst's  abihty  to  help  (p.  45). 

Some  of  you  will  no  doubt  recognize  the  foregoing 
quotation  as  a  part  of  R.  H.  Berg's  recent  article  in  Look 
Magazine  to  which  I  made  reference  earlier.  Another 
argument  which  is  sometimes  advanced  is  that  what  the 
analyst  offers  the  patient  is  primarily  his  close  attention 
as  the  patient  talks  and  that  if  he,  the  analyst,  has  any 
financial  worries  he  is  likely  to  be  distracted  by  his  own 
problems. 

Dr.  Haak  conjectures  that  anything  that  comes  cheap 
is  likely  to  be  perceived  as  being  of  little  value.  More 
pertinent  to  the  situation  would  be  the  observation  that 
a  commodity,  such  as  psychoanalysis,  can  cost  a  lot  and 
still  be  worthless,  except,  as  he  implies,  for  the  masochis- 
tic or  symptomatic  relief  it  involves.  I  submit  that  if  we 
need  to  make  a  sacrifice,  there  are  morally  and  socially 
more  relevant  ways  of  doing  this  than  supporting  a  psy- 
phoanalyst  in  a  penthouse. 

I  But  this  is  something  of  a  digression.  The  point  I  want 
to  make  is  this.  Mere  thinking,  talking,  analyzing  will 
not  save  us;  our  final  redemption  can  only  be  found  in 
1  radically  changed  life  style.  The  capacity  to  make  such 
1  change  is  often  dependent,  at  least  to  some  extent, 
jpon  new  visions,  new  conceptions  which  we  acquire 
ntellectually;  and  it  is  upon  this  assumption  that  I  sug- 
gest we  continue  our  attempt  to  clarify  certain  matters 


142  The  Crisis  in  Psychiatry  and  Religion 

which  currently  seem  to  be  the  source  of  considerable 
confusion. 

III.    THE   PROBLEM   OF   EVIL 
EMPIRICALLY   IDENTIFIED 

If  a  significant  aspect  of  our  great  sickness  as  a  people 
and  as  a  society  is  that  we  speak  of  sickness  rather  than 
of  sin,  and  guilt,  and  evil,  then  it  follows  that  we  must 
reconsider  these  concepts.  This,  however,  is  not  easy  for 
us.  We  are  unaccustomed  to  thinking  in  these  terms  and 
find  them  quite  uncongenial.  At  the  opening  meeting  of 
a  graduate  seminar  this  semester,  the  very  first  question 
raised  by  the  students  was:  But  what  is  guilt?  Psycholo- 
gists and  psychiatrists,  along  with  many  religious  leaders 
and  the  general  laity,  have  been  taught  to  think  in  terms 
of  guilt  feelings,  that  is  to  say,  a  sense  of  guilt  which  is 
unrealistic  and  nonfunctional  and  which  you  can  get  rid 
of  only  if  you  can  find,  and  afford,  a  really  ''good" 
therapist.  The  notion  that  guilt  is  real  and  not  to  be 
banished  by  mere  talk  or  ''counseling"  or  "analysis"  is 
quite  beyond  our  common  comprehension. 

Historians  of  the  future  may  be  able  to  discern  more 
clearly  than  we  do  today  the  circumstances  which  caused 
us,  as  a  people,  to  drift  into  this  remarkable  condition. 
No  doubt  the  true  and  complete  explanation  is  complex; 
but  a  prominent  factor  in  the  situation  which  I  believe 
we  can  already  see  with  some  clarity  is  that  the  traditional 
guardians  of  our  moral  and  spiritual  values  have  insisted 
upon  speaking  of  these  matters  in  terms  and  in  a  con- 
text which  are  no  longer  very  meaningful  to  the  mental- 
ity and  thought  forms  of  modern  man.  One  of  the  rea- 
sons, I  believe,  for  the  current  popularity  of  Paul  Tillich 
as  a  theologian  is  that  he  has  had  the  courage  and  dis- 
cernment to  be  so  nontheological  in  the  conventional 
sense  of  that  term.  Recently  I  met  with  a  group  of  minis- 
ters who  quickly  identified  me,  in  their  minds,  as  an  un- 
regenerate  naturalist  and  not  at  all  to  their  theological 
taste;  and  a  few  hours  later  I  met  with  a  university  faculty 
group,  in  the  same  community,  who  perceived  my  posi- 
tion as  morally  reactionary,  unscientific,  and,  as  far  as 
they  were  concerned,  theological  and  supernaturalistic. 
More  than  anything  that  has  happened  in  a  long  time, 


Psychology,  Theology,  and  Social  Self  143 

this  experience  brought  home  to  me  the  extent  of  our 
diversity  and  confusion  and  our  egregious  lack  of  unity 
in  this  area.  This  is  not,  I  beHeve  we  would  all  agree,  a 
healthy  state  of  affairs.  There  is,  in  our  time,  no  social, 
moral,  and  ethical  solidarity  and  confidence.  The  diffi- 
culty with  the  position  of  traditional  theology  is  that  its 
logic  and  thought  forms  are  foreign  to  the  modern  mind; 
and  the  problem  for  the  individual  who  is  imbued  with 
what  he  believes  to  be  a  thoroughly  scientific  and  objec- 
tive world  view  is  that  he  may  be  unable  to  find  therein 
any  place  for  moral  values,  standards,  and  ethics.  Tradi- 
tional theology  was  the  original  thesis  (if  we  may  use 
the  familiar  Hegelian  paradigm);  scientific  naturalism 
has  been  the  strident  antithesis;  and  from  this  clash 
must  come,  I  believe,  a  new  synthesis  of  some  kind 
(Mowrer,  1959).  I,  personally,  cannot  envision  this  new 
ethical  frame  of  reference  with  great  clarity;  but  there 
is  one  facet  of  the  picture  which  seems  to  me  perfectly 
definite. 

There  is,  in  our  time,  a  widespread  distrust  of  moral 
injunctions  and  values  which  is  at  least  rationalized  by 
the  following  argument.  To  be  good,  it  is  argued,  is  to 
conform  to  existing  rules  and  social  prescriptions;  and 
these,  it  is  pointed  out,  may  be  either  outmoded  or 
otherwise  nonfunctional;  and  if  we  obey  them,  then  we 
perpetuate  them  and  so  are  not  being  good  but,  in 
reality,  stupid  and  evil. 

Some  years  ago  I  recall  a  young  married  woman  who 
came  to  me  in  considerable  distress  because  her  husband, 
with  whom  she  was  very  much  in  love,  "played  around," 
as  she  put  it,  with  other  women  when  they  went  to 
social  parties.  The  husband,  who  also  valued  the  marriage 
and  by  no  means  wished  to  lose  his  wife,  later  agreed  to 
come  in  for  a  talk;  and  it  soon  came  out  that  he  justified 
his  philandering  at  parties  on  the  grounds  that  he  aspired 
to  be  a  writer  and  felt  that  he  needed  a  little  extra  titilla- 
tion  and  romance  in  order  to  be  "creative." 

In  a  sort  of  microcosm,  this  marital  situation  symbol- 
izes at  least  a  part  of  our  larger  problem:  we  pretend 
to  be  afraid  of  convention  and  morality  and  social  regula- 
tion and  order  on  the  grounds  that  it  will  stifle  so-called 
rogress,  invention,  discovery,  creativeness.  One  imme- 
iately  sees,  of  course,  how  easily  such  a  formula  can  be 


144  The  Crisis  in  Psychiatry  and  Religion 

used  to  justify  and  excuse  the  most  blatant  instances  of 
immaturity,  selfishness,  and  moral  laxity.  There  is,  how- 
ever, a  legitimate  side  to  this  argument  which  must  be 
faced.  Leaving  aside  those  who  are  obviously  exploiting 
this  dilemma  in  a  personal  way,  there  are  many  contem- 
porary men  and  women  who  are  sincerely  wondering  how 
one  can  be  good,  in  the  sense  of  conforming  to  an  es- 
tablished social  code  or  system,  without  also  losing  that 
spontaneity  and  creativity  which  we  so  greatly  value  today 
and  regard  as  essential  to  meeting  the  unpredictable 
needs  of  our  changing  civilization.  Here,  surely,  is  the 
essence  of  our  dilemma:  on  the  one  hand  we  seem  to 
find  that  the  penalty  for  disregarding  the  rules  of  society 
is  mental  illness  and  that,  on  the  other  hand,  we  must 
preserve  our  freedom  to  change  and  try  new  ways  of  life. 

Actually,  I  do  not  believe  this  paradox  is  half  so  diffi- 
cult as  we  sometimes  try  to  persuade  ourselves,  and  so 
suggest  the  following  way  of  looking  at  it.  Let  us  imagine 
a  man  (which  is  not  hard  to  do)  who  does  not  like  to 
pay  his  income  tax.  He  has,  as  I  see  it,  four  alternatives: 

L  He  can  pay  his  tax,  accurately  and  honestly,  and 
say  nothing  about  his  disgruntlement.  He  may  feel  that, 
given  the  present  state  of  world  affairs,  there  is  not  much 
he  can  do  about  the  problem  and  that  he  is,  in  any  event, 
more  interested  in  other  things.  Now  despite  the  wide- 
spread presumption  (stemming  from  Freudian  theory) 
that  it's  bad  for  us  not  to  express  our  annoyance,  there 
is  not  the  slightest  evidence  that  this  sort  of  restraint 
ever  made  anyone  emotionally  ill  or  destroyed  his  char- 
acter. It  may  not  be  the  most  ''creative'^  way  imaginable 
of  meeting  situations  of  this  kind,  but  it  is  at  least  a 
perfectly  respectable  and  safe  one. 

2.  Or,  a  man,  faced  by  the  tax  dilemma,  can  again 
pay  his  taxes,  accurately  and  honestly,  but  then  make 
whatever  protest  he  feels  is  in  order.  In  this  particular 
instance,  he  is  likely  to  discover,  rather  quickly,  that  just 
grumbling  accomplishes  little  or  nothing  and  that  he 
must  look  for  the  conditions  and  causes  behind  the 
present  tax  situation.  He  may,  as  a  result,  become 
staunch  supporter  of  the  United  Nations,  as  a  vehicle 
for  promoting  greater  international  law  and  order,  thus 
lessening  the  threat  of  war  and  the  necessity  for  ruinously 
costly  competition  in  the  arms  race.  The  point  is  that 


Psychology,  Theology,  and  Social  Self  145 

just  because  one  scrupulously  obeys  a  law  or  regulation 
does  not  in  the  least  mean  that  one  cannot  work — 
openly,  honorably,  and  effectively — for  its  modification. 

3.  Or,  our  hypothetical  individual  can  pay  none  or 
only  a  part  of  his  income  tax  as  an  open  and  avowed 
protest.  He  may  be  sent  to  prison  for  his  pains;  but  we 
must  not  forget  that  the  method  is  an  honest  one  and 
can  be  extremely  powerful.  In  modern  times  one  of  the 
most  dramatic  examples  of  its  effectiveness  was  the 
campaign  of  nonviolent  resistance  to  British  rule  which 
Gandhi  and  his  followers  mobilized  in  India.  The  Indians 
were  oppressed,  to  mention  only  one  example,  by  the 
price  of  salt,  which  was  a  government  monopoly,  and 
were  forbidden  (by  what  were  known  as  the  odious  Salt 
Laws)  to  make  salt  for  themselves  from  the  seawater 
which  was  freely  available  to  them.  So  Gandhi  announced 
that  he  was  going  to  walk  a  distance  of  some  hundred 
and  twenty  miles  to  the  sea  and  openly  make  salt  in 
defiance  of  the  regulations  of  the  British  government; 
and  he  invited  others  to  join  him,  which  they  did  by  the 
hundreds.  "'When  attacked,  beaten,  or  imprisoned  by 
the  officials,  do  not  resist,  do  not  flee,  do  not  fight  back," 
Gandhi  urged.  "Our  oppressors  will  soon  have  no  heart 
for  beating  us  further,  and  the  Salt  Laws  will  be  re- 
voked." As  a  result  of  this  heroic  March  to  the  Sea, 
as  it  is  now  called,  the  Salt  Laws  were  revoked;  and 
eventually  application  of  the  same  powerful  strategy — 
of  open,  nonviolent  resistance — completely  broke  British 
rule  and  resulted  in  a  Free  India.  Here,  surely,  was  a 
power,  a  moral  power,  more  effective  than  club,  sword, 
gun,  or  bomb.  Limited  nonconformity  with  openness, 
integrity,  and  courage  is  available  to  us  all,  at  all  times; 
and  it  can  be  as  mighty  as  the  mustard  seed  alluded  to 
by  Christ  in  the  parable. 

I  say  limited  nonconformity.  Why  limited?  Because, 
in  the  example  given,  Gandhi  and  his  followers  were,  in 
fact,  scrupulously  observing  a  higher  law  than  the  one 
they  were  violating:  they  kept  their  honor,  their  openness, 
their  integrity — and  the  world  respected  and  will  not 
soon  forget  them.  This   observation  now  leads  us,  by 

I  contrast,  to  the  fourth  way  in  which  one  may  try  to 
deal  with  a  rule  or  regulation  which  one  finds  incon- 
venient or  otherwise  objectionable. 


146  The  Crisis  in  Psychiatry  and  Religion 

4.  Let  us  return  to  the  income-tax  example.  Here  the 
individual  again  does  not  pay  his  tax  or  pays  it  only  ; 
partially,  but  then  implies  or  claims  that  he  has  paid  ; 
it  in  full.  His  legal  crime  is  thus  compounded  by  deceit, 
hypocrisy,  and  dishonor.  And  far  from  making  a  man  I 
strong,  as  Gandhi's  Salt  March  did  for  those  who  took  ; 
part  in  it,  this  strategy  destroys  personality.  In  our  time ' 
two  seemingly  unrelated  things  have  happened:  on  the  | 
one  hand,  mental  illness  has  defied  our  best  efforts  to  i 
understand  and  control  it;  and,  on  the  other  hand,  we 
have  developed  a  widespread  distrust  of  moral  law  and 
principle.  Only  recently,  within  the  last  few  years,  have 
we  come  to  realize  that  there  may  here  be  a  very  vital 
and   important   connection.    Some   of   us   now   suspect 
hidden  guilt  as  being  the  central  problem  in  all  psycho 
pathology.  Integrity  and  integration,  we  note,  come  from 
the  same  root:  and  it  now  appears  that  we  cannot  have 
one  without  the  other.   Cheating  and   chiseling   erode 
character  as  they  devitalize  society.   If  we  accept  the 
benefits  and  privileges  of  a  given  social  system,  then  we 
are  honor-bound  to  observe  the  regulations  and  rules  of 
that  system,  unless  we  are  willing  to  defy  the  system 
openly  and  take  the  consequences  thereof. 

Obviously  one  can  think  of  abnormal  conditions  such 
as  when  a  country  is  over-run  by  an  enemy  or  such  as 
the  Jews  encountered  in  Nazi  Germany  in  which  all 
manner  of  ethical  dilemmas  arise.  But  the  circumstances 
under  which  most  of  our  crack-ups  occur  involve  no 
unusual  or  extenuating  circumstances.  Of  course,  we 
hear  much  today  about  how  our  society  as  a  whole  is 
"sick"  and  that  one  can  survive  only  if  one  defies — 
rather  than  obeys — it.  This,  again,  seems  to  me  to  over- 
look a  very  elementary  distinction,  namely,  that  between 
personal  sin  and  corporate  sin.  Vance  Packard  is  entirely 
correct  when  he  points  out  that  whereas  we  once  looked 
upon  waste  and  conspicuous  consumption  as  an  evil,  we 
now  are  openly  encouraged  in  it  as  an  aid  to  an  ''expand 
ing  economy."  I  believe  that  in  our  world  the  doctrine 
of  an  "expanding  economy"  is  an  evil,  but  it  is  a  cor 
porate  evil.  By  its  very  nature  it  is  public,  and  we  are  all 
more  or  less  involved  in  it.  The  time  will  come,  I  predict, 
when  we  are  going  to  repent  it  bitterly;  but  I  don't  think 
it's  going  to  make  anyone  go  crazy.  The  very  fact  that 


Psychology,  Theology,  and  Social  Self  147 

we  are  all  in  it  together  means  that  there  is  no  loss  of 
sociahty,  no  estrangement  from  the  significant  others, 
and  so  no  madness. 

By  contrast,  personal  sins  are  those  which  the  com- 
munity does  not  condone,  may  in  fact  severely  censure, 
and  which  the  individual,  if  he  commits  them  at  all, 
commits  privately,  secretly.  Blind  and  unwise  as  our 
society  may  be  in  its  current  economic  presuppositions, 
it  is  still  pretty  well  consolidated,  it  seems,  with  respect 
to  a  lot  of  things;  and  it  is  in  the  areas  in  which  virtually 
everyone  is  at  least  overtly  agreed  that  personal  sin, 
secrecy,  and  psychopathology  follow  in  that  order.^  Re- 
cently I  heard  a  state  hospital  psychiatrist  comment  on 
how  frequently  incest  figures  in  the  background  of  the 
patients  whom  she  sees.  Does  anyone  really  think  that 
incest  is  a  fine  thing  and  ought  to  be  generally  practiced? 
I  doubt  it.  Yet  it  does  occur,  and  I  do  not  believe  anyone 
can  long  bind  his  guilt  with  respect  to  it  by  talking  about 
the  moral  absurdities  and  ambiguities  "of  society."  Be- 
sides, as  I  have  tried  to  show,  there  is  a  perfectly  straight- 
forward way  of  fighting  corporate  sin  without  in  the  least 
compromising  oneself,  i.e.,  falling  into  personal  sin. 
Personal  sin  occurs,  as  I  see  it,  and  sows  the  seed  of 
psychological  destruction  when  and  only  when  the  in- 
dividual violates  a  social  injunction  or  regulation  but 
pretends  that  he  has  not. 

I  wish  to  conclude  this  section  with  a  moving  and 
prophetic  quotation  from  Dietrich  Bonhoeffer.  In  his 
book,  Life  Together,  he  says: 

In  confession  the  break-through  to  community  takes 
place.  Sin  demands  to  have  a  man  by  himself.  It  withdraws 
him  from  the  community.  The  more  isolated  a  person  is,  the 
more  destructive  will  be  the  power  of  sin  over  him,  and  the 
more  deeply  he  becomes  involved  in  it,  the  more  disastrous 
is  his  isolation.  Sin  wants  to  remain  unknown.  It  shuns  the 

°  Occasionally  I  have  been  invited  to  expatiate  on  the 
concept  of  Original  Sin.  If  I  allowed  myself  to  do  so,  I  would 
really  lay  myself  open  to  the  charge  from  theologians  of  prac- 
ticing their  profession  without  a  license.  But,  for  whatever  it 
may  be  worth,  my  untutored  layman's  opinion  is  that  this 
doctrine  is  nonsense,  as  is  that  of  the  Substitutionary  Atone- 
ment, and  has  done  much  harm  in  the  world  [cf.  Chapters 
11  and  12]. 


148  The  Crisis  in  Psychiatry  and  Religion 

light.  In  the  darkness  of  the  unexpressed  it  poisons  the  whole 
being  of  a  person  (p.  112). 

And  Eric  Fromm,  in  his  book  The  Art  of  Loving, 
says  without  equivocation,  that  the  loss  of  relatedness 
and  community  is  the  ground  of  anxiety  and  the  begin- 
ning of  insanity  (see  also  Kirkendall,  1960). 

IV.   A  NATURALISTIC   PARAPHRASE 
OF   PERDITION  AND   REDEMPTION 

If  the  foregoing  analysis  is  sound,  the  condition  which  i 
we  currently  refer  to  as  neurosis  or  psychosis  is  the  same 
as  that  which  an  earlier  era  knew  as  a  state  of  sin  or  dis- 
grace; and  the  defining  characteristic  of  both  is  the 
presence  in  one's  life  of  shameful  secrets.  When  Have- 
lock  Ellis  was  once  asked  what  he  thought  of  Freud's 
ideas,  he  dismissed  the  question  by  saying  that,  in  his 
opinion,  personality  difficulties  are  due,  not  to  the  uncon- 
scious, but  to  the  unuttered.  Freud's  theory  has,  however,, 
had  a  diabolical  fascination  for  us;  and  it  is  only  now 
that  we  are  beginning  to  realize  how  thoroughly  mislead- 
ing and  destructive  it  is. 

If  it  is  indeed  the  untold  rather  than  the  unknown 
that  devastates  us  as  persons  and  robs  our  lives  of  joy 
and  meaning,  how  can  this  view  of  the  matter  be  given; 
a  theoretical  formulation  approaching  in  elegance  and 
plausibility  that  of  psychoanalysis?  In  a  moment  I  shall, 
have  a  suggestion  to  make  in  this  connection,  but  first  a 
collateral  observation.  When  a  neurotic  (sinful?)  person; 
is  asked,  ''What  makes  you  so  anxious,  so  depressed,  so 
distraught?"  he  is  likely  to  reply  that  he  does  not  know.: 
And  the  Freudian  rejoinder  is  then,  typically,  "Yes,  that 
is  true.  You  don*t  know  the  causes  of  your  troubles.  ^ 
They  are  repressed,  unconscious,  and  thus  beyond  your: 
unaided  capacity  to  deal  with.  How  fortunate,  therefore,' 
that  psychoanalysis  is  available  to  you  as  a  method  of 
making  the  unconscious  conscious  and  thus  helping! 
you  discover  the  real  origin  of  your  difficulties  and  mak- 
ing you  then  able  to  deal  rationally  with  them." 

I  remember  hearing  John  Dollard  some  years  ago, 
when  we  were  both  on  the  staff  of  the  Yale  Institute 
of  Human  Relations,  once  remark  that  whatever  Freud's 


Psychology,  Theology,  and  Social  Self  149 

scientific  contributions  might  be,  he  had  certainly  started 
a  big  business.  Now,  more  clearly  than  before,  we  can 
see  the  nature  of  that  business.  Certainly  no  one  is  going 
to  get  rich  telling  others  that  their  emotional  turmoil 
comes  from  unconfessed  and  unexpiated  sin.  That  road 
to  redemption  is  too  rough,  and  we  shun  even  the 
thought  of  it  if  we  possibly  can.  The  Freudian  doctrine 
is,  of  course,  very  different — far  more  pleasant  sounding 
and  appealing.  According  to  it,  we  are  not  "to  blame" 
for  our  suffering;  but — and  here  is  the  joker — ^by  the 
same  token  neither  can  we  do  anything  about  our  condi- 
tion by  ourselves.  Only  the  psychoanalyst  can  save  us; 
and  this  he  is  very  willing  to  do,  he  says,  provided  we 
can  pay  him  sufficiently  well  for  his  eflforts.  For  the  poor, 
as  the  Hollingshead-Redlich  New  Haven  study  has 
shown,  psychoanalysis  has  never  been  a  live  option;  and 
it  is  no  accident  that  it  is  among  them  that  we  find  other, 
simpler,  and  more  radically  effective  methods  of  salvation 
at  work.  Also,  as  Bonhoeffer  in  his  book.  The  Cost  of 
Discipleshipy  has  indicated,  many  Christian  churches 
have  similarly  tried  to  provide,  for  those  who  can  afford 
it,  a  doctrine  of  salvation  through  forgiveness  uncom- 
plicated by  personal  embarrassment,  genuine  contrition, 
and  meaningful  restitution.  This,  Bonhoeffer  has  called 
"the  doctrine  of  cheap  grace";  and  because  it  is  cheap, 
in  personal  involvement,  sacrifice,  and  change,  it  is  no 
grace  at  all.  Despite  its  exorbitant  fees,  psychoanalysis 
also  preaches  a  doctrine  of  cheap,  easy  grace.  If  you  can 
only  pay  for  it,  buy  it,  someone  else  will  do  the  real  work 
of  curing  you,  while  you  lie  comfortably  on  a  couch. 

One  of  the  crying  needs  of  our  time,  surely,  is  for  a 
therapeutic  (redemptive)  alternative  which  is  available 
to  the  well-to-do,  without  carrying  the  illusion  that  we 
Can  purchase  it  with  mere  money  instead  of  at  the  per- 
gonal cost  which  the  poor  have  always  had  to  accept. 
Jesus  Christ,  we  need  to  remind  ourselves,  was  a  poor 
Itnan.  He  and  his  disciples  moved  about  on  foot,  preached 
land  taught  in  the  open,  without  benefit  of  costly  church 
or  temple,  and  their  appeal  was  to  the  poor.  I.  A.  Rich- 
ards once  observed,  ironically,  that  every  profession  is 

conspiracy  against  the  laity.  The  truth  of  this  statement 
lES  regards  psychoanalysis  needs  no  elaboration.  In  a 
'slightly  more  benign  way,  the  same  charge  can,  I  believe, 


150  The  Crisis  in  Psychiatry  and  Religion 

also  be  directed  against  theologians  and  clergymen.  In 
the  Catholic  Church,  they  openly  claim  to  derive  their 
unique  power  to  forgive  sins  as  a  result  of  the  so-called 
direct  apostolic  succession.  And  while  making  no  such 
claim  in  this  area,  Protestant  theologians  surround  Chris- 
tianity with  other  mysteries  which  only  they  can  presum- 
ably interpret.  I  take  it  as  suggestive,  again,  that  the 
most  radically  redemptive  enterprises  which  we  today 
know,  notably  the  Salvation  Army  and  Alcoholics  Anony^ 
mous,  are  lay  movements  with  their  ''leaders"  coming, 
not  from  our  universities  and  seminaries,  but  from  the 
Tanks  of  their  own  converted  and  transformed  personnel. 
Here  the  Priesthood  of  All  Believers  is  more  than  a  high- 
sounding  Reformation  slogan;  it  is  a  living  reality. 

But  to  return,  now,  to  the  attempt  to  schematize  the 
strategy  of  deception  and  personal  fraudulence  which, 
we  conjecture,  is  the  uniform  precondition  of  emotional 
or,  as  we  might  better  say,  moral  disturbance.  Freud 
thought  in  vivid,  graphic  similes  and  communicated  his 
ideas,  abhorrent  though  they  were,  in  a  clear  and  mem- 
orable way.  Only  the  parables  of  Christ  himself  compare 
perhaps  in  trenchancy  and  heuristic  aptness  and  are 
actually  inferior,  at  least  by  modern  standards,  as  a  con- 
ceptual scheme.  Hence,  the  task  of  formally  systematizing 
the  alternative  to  Freudianism  which  seems  to  be  emerg- 
ing— or,  rather,  re-emerging — remains  for  the  future.  The 
sociologist,  George  Herbert  Mead,  made  some  notable 
steps  in  this  direction,  as  did  Harry  Stack  Sullivan  within 
the  psychiatric  framework  and  also  Martin  Buber,  as  i 
theologian.'^  Here  I  shall  make  no  attempt  to  revie>^ 
or  synthesize  their  respective  contributions  but  will  in 
stead  suggest  a  heuristic  device  which  I  have  found  effec- 
tive on  other  occasions. 

In  class  one  day  I  found  myself  drawing  a  straight  line 
across  the  blackboard,  from  left  to  right,  as  a  means  ol 
depicting  normal,  upright  day-to-day  human  living.  A. 
morally  and  emotionally  healthy  person,  in  commor 
parlance,  is  said  to  be  on  the  up-and-up,  predictable 
consistent,  a  straight  shooter.  This  is  not,  of  course,  tc 

"^  Of  special  interest  in  this  connection  is  a  book  by  P.  E 
Pfuetze  which  systematically  relates  and  compares  the  writing: 
of  Mead  and  Buber.  This  book,  significantly,  is  entitled  Thi 
Social  Self.  [See,  also.  Chapter  11.] 


Psychology,  Theology,  and  Social  Self  151 

say  that  such  a  person  is  perfect.  From  time  to  time, 
even  the  best  of  men  and  women  "stumble,"  "sHp/'  or 
momentarily  "fall."  But  they  know  how  to  correct  their 
errors,  how  to  pick  themselves  up,  redeem  themselves. 
I  once  heard  a  colored  attendant  in  a  mental  hospital 
remark  to  a  patient:  "The  Good  Book  says,  when  you 
dowrij  don't  wallow!"  And  the  psychiatrist,  David  Levy, 


Fig.  1.  A  crude  attempt  to  diagram  normal  and  abnormal 
life  styles.  The  top  horizontal  line,  with  its  occasional  imperfec- 
tions or  "dips"  but  essentially  straight  course  {from  left  to 
right),  represents  ongoing  existence  in  a  normal,  emotionally 
and  morally  healthy  individual.  When  such  a  person  makes  a 
mistake,  he  corrects  it  and  "goes  on."  But  some  individuals, 
while  pretending  to  be  "on  the  level,"  allow  themselves  to  "sink 
\in  sin,"  as  shown  by  the  descending,  lower  line.  Because  of  the 
danger,  strain,  and  self -revulsion  involved  in  such  a  "double 
life,"  the  individual  eventually  experiences  a  crisis  {at  X);  his 
sins  "catch  up"  with  him  and  he  is  overwhelmed  by  guilt  and 
anxiety.  Now  his  option  is  a  slow,  painful  "come-back"  {as- 
cending line)  or  further  withdrawal  from  the  whole  human  en- 
terprise {descending  broken  line),  in  the  form  of  suicide, 
chronic  paranoia,  or  general  deterioration.  The  diagram  could 
perhaps  be  usefully  elaborated  to  show  how  some  persons,  as  a 
result  of  crisis  experience,  also  rise  to  "new  heights."  But,  as  it 
stands,  the  diagram  illustrates  the  most  essential  features  of 
the  present  analysis. 

voices  the  same  thought  when  he  says  that  one  of  the 
hallmarks  of  good  character  and  emotional  health  is 
resiliency,  bounce.  Therefore,  I  would  modify  the  straight 
line,  as  shown  in  the  accompanying  figure,  so  as  to  pro- 
vide for  periodic  dips  and  recoveries,  imperfections,  dents, 
but  not  nose  dives. 

However,  not  everyone  has  the  strength  of  character 
or  wisdom  to  correct  his  mistakes,  promptly  and  fully. 


152  The  Crisis  in  Psychiatry  and  Religion 

which  means  that  when  he  shps  he  takes  a  real  plunge, 
as  shown  by  the  lower  line  in  the  figure.  Let  me  suggest 
an  illustration.  A  bank  employee  needs  a  little  extra 
money  for  a  few  weeks.  He  has  access  to  stacks  of  cur- 
rency which  he  knows  will  not  otherwise  be  used  during 
this  period  so  decides  to  "borrow"  some  of  it,  with  the 
full  intention  of  replacing  it.  But  his  affairs  do  not  move 
as  he  had  hoped,  and  he  is  unable  to  replace  the  money 
and,  in  fact,  soon  finds  himself  in  need  of  another  ''loan." 
And  each  time  he  thus  illegally  helps  himself,  it  becomes 
easier  to  do  so  again,  the  thought  of  restitution  becomes: 
more  and  more  remote — and  our  friend  is  soon  a  con- 
firmed embezzler.^ 

Now  for  a  time  things  may  go  smoothly  with  this 
fellow,  and  he  may  even  regret  his  not  having  adopted 
such  a  procedure  earlier.  But  he  is,  of  course,  in  constant 
jeopardy,  as  indicated  by  the  discrepancy  between  the  top 
line,  which  is  what  he  pretends  to  be  (namely,  an  honest 
bank  employee),  and  the  bottom  line,  which  represents 
the  level  to  which  he  himself  knows  he  has  sunk.  Even- 
tually, of  course,  something  nearly  always  happens,  and 
our  embezzler  ''gets  caught";  that  is  to  say,  there  is  a 
crisiSf  which  is  represented  by  the  large  X  in  the  diagram. 
Now  the  choice,  if  he  has  one,  is  between  slow,  painful 
repayment  or  "restitution"  (see  the  ascending  line)  and 
criminal  proceedings,  imprisonment,  disgrace,  and,  not 
inconceivably,  suicide  (descending  line). 

Here  the  crime  is  a  financial  and  legal  one  but  it 
nevertheless  provides  a  good  model  for  moral  defection 
and  human  "bankruptcy."  Mistakes  or  sins  of  an  inter- 
personal character  which  are  unacknowledged  and  unre-; 
deemed  also  involve  delinquency  and  deception;  and 
although  things  may  seemingly  go  nicely  for  a  time, 
something  likewise  eventually  happens  which  precipitates 
a  crisis,  but  now  within  the  individual's  own  mind  or 
"soul" — and    So-and-So,   we   say,   has   had   a   "nervous 

®  In  a  recent  study,  Cressey  (1953)  points  out  that  a  part 
of  the  embezzler's  "problem"  is  that  it  is  "unsharable,"  This 
state  of  affairs,  it  seems,  characterizes  many  other  situations 
which  get  human  beings  into  emotional  or  legal  difficulties.  It 
is  an  essential  feature  of  the  present  argument  that  no  one  eva 
goes  to  prison  or  to  a  mental  hospital  who  has  (or  had)  noth- 
ing "to  hide." 

.^ 


Psychology,  Theology,  and  Social  Self  153 

breakdown."  The  fact  is,  he  probably  has  been  down 
for  some  time,  so  that  we  could  speak  more  properly  of 
an  attack  or  outbreak  of  conscience.  We  say  that  the 
individual  has  become  mentally  ill,  emotionally  sick,  and 
needs  "treatment."  But  it  is  probably  more  discerning 
to  say  that  he  has  been  ''sick"  for  quite  some  time  and 
that  what  we  now  perceive  as  manifest  "illness"  is  really 
an  inner  revulsion  against  a  duplicitous  and  disgraceful 
life  style  and  an  attempt,  as  Boisen  would  say,  at  correc- 
tion and  cure.^  I  believe  it  is  not  inaccurate  to  posit 
that  virtually  all  of  our  contemporary  efforts  to  deal  with 
the  psychoneuroses  are  aimed  at  symptoms,  and  do  not 
get  to  the  real  root  of  the  matter,  and  so  remain  ineffec- 
tive. Note  how  often  we  speak  of  restoring  the  individual 
to  his  former  self,  when  not  restoration  but  reformation 
is  what  is  needed. 

As  if  at  last  awakening  to  the  absurdity  of  this  ap- 
■  proach,  we  are  beginning  to  ask  again  the  question: 
What  is  the  true  and  ultimate  nature  of  man?  We 
were  willing,  for  a  time,  to  accept  Freud's  dictum  that 
man  is  pre-eminently  an  animal,  an  organism,  whose 
ultimate  destiny  and  fulfillment  rests  in  his  instinctual 
life.  This  view  we  now  distrust,  and  are  rediscovering 
man's  inveterate  sociality  and  morality.  Freud  said  that 
the  alienation  which  is  involved  in  personality  disturb- 
ance is  between  man's  conscious  mind  and  his  body  or, 

°  It  goes  without  saying  that  a  person  does  not  necessarily  risk 
mental  illness  when  he  abandons  one  set  of  social  and  ethical 
standards  and  drops  down  to  a  "lower"  level  of  functioning.  If 
a  person  makes  this  sort  of  transition  openly,  we  may  say  that 
he  is  a  "black  sheep"  or  (in  sociological  jargon)  downward 
mobile;  but  since  his  defection  is  a  matter  of  public  knowl- 
edge and  carries  its  own  natural  and  immediate  consequences, 
such  a  person's  mental  health  is  not  in  jeopardy.  It  is  the  per- 
son who  continues  to  lay  claim  to  full  membership  in  a  group 
whose  standards  he  is  secretly  disregarding  who  is  prey  to  "bad 
,  conscience"  and  "mental  illness."  Also,  we  should  note  that 
"recovery"  from  such  a  state  of  affairs  is  never  easy.  As  the 
diagram  illustrates,  it  is  a  decidedly  "up-hill"  business;  and  it 
is  totally  unrealistic  to  encourage  such  persons,  either  in  the 
\  context  of  secular  psychotherapy  or  religious  conversion,  to  be- 
I  lieve  that  their  "salvation"  can  be  simple  and  easy.  Salvation  is, 
nonetheless,  possible;  and  it  is  our  obligation  to  see  and  delin- 
eate that  possibility  clearly  and  accurately. 


154  The  Crisis  in  Psychiatry  and  Religion 

in  terms  of  the  title  of  one  of  his  theoretically  most 
significant  books,  between  The  Ego  and  the  Id.  Our 
perception  is  now  changing  and  we  see  that  the  battle- 
ground lies,  rather,  between  the  individual  and,  again  to 
quote  Boisen,  "that  social  something  we  call  God." 

Over  the  main  entrance  to  Emerson  Hall,  which  used 
to  house  psychology  and  philosophy  at  Harvard,  is  en- 
graved the  Old  Testament  query  or,  more  properly,  awe- 
inspired  exclamation:  "What  is  man  that  Thou  art 
mindful  of  him?"  For  a  time  it  looked  as  if  God  had 
forgotten  us,  as  we  had  abandoned  and  turned  away 
from  Him.  But  if  it  is  indeed  the  Holy  Spirit  that  is 
working  in  us  when  we  are  "disturbed"  and  "emotion- 
ally sick"  [see  Chapter  9],  then  God  is  very  much  with 
us,  indeed,  and  it  behooves  us  to  seek  Him  out  on 
friendlier  terms,  that  we  may  be  spared  knowing  Him 
only  in  His  Wrath  and  Vengeance.^^ 

I  hope  that  none  of  you  will  feel  that  in  these  lectures 
I  am  purporting  to  say  anything  new  or  original,  except 
in  a  very  superficial  and  transitory  way.  One  of  Harry 
Emerson  Fosdick's  published  sermons  is  entitled  "Redig- 
ging  Old  Wells."  And  here  Fosdick  describes  the  great 
watering  places  which  the  patriarch,  Abraham,  planned 
and  provided  at  strategic  points  in  Palestine.  When  the 
Philistines  pillaged  the  land,  these  wells  were  despoiled 
and  filled;  and  Abraham's  son,  Isaac,  made  it  his  business 
to  re-open  the  well-springs  of  his  father.  Just  because 
something  is  old  is  no  reason  to  think  it  is  necessarily 
unsound  or  inferior.  Although  I  hold  no  brief  for  the 
metaphysical  baggage  which  the  Judeo-Christian  Ethic 
has  accumulated  in  the  course  of  2,000  years,  I  do  main- 
tain that  this  Ethic  embodies  some  perduring  verities 
which  we  can  today  ignore  only  at  our  deadly  peril. 
Surely  the  author  of  the  139th  Psalm  glimpsed  the 
eternal  when  he  wrote: 

"It  has  become  unfashionable  (see  also  Chapter  5  to  talk 
about  the  wrath  of  God.  I  am  indebted  to  Dr.  Elmer  Million 
for  calling  to  my  attention  the  statement  (by  an  unidentified 
author)  to  the  effect  that  the  "wrath  of  God"  is  the  way  in 
which  those  who  oppose  His  will  experience  His  love.  The  im- 
plications of  this  way  of  viewing  the  matter  for  child-parent 
relationships  and  practices  are  clear  and  illuminating. 


Psychology,  Theology,  and  Social  Self  155 

Whither  shall  I  go  from  thy  spirit?  or  whither  shall  I 
flee  from  thy  presence? 

If  I  ascend  up  into  heaven,  thou  art  there:  if  I  make 
my  bed  in  hell,  behold,  thou  art  there. 

If  I  take  the  wings  of  the  morning,  and  dwell  in  the 
uttermost  parts  of  the  sea; 

Even  there  shall  thy  hand  lead  me,  and  thy  right  hand 
shall  hold  me. 

If  I  say,  surely  the  darkness  shall  cover  me;  even  the 
night  shall  be  light  about  me. 

Yea,  the  darkness  hidest  not  from  thee;  but  the  night 
shineth  as  the  day:  the  darkness  and  the  light  are  both 
alike  to  thee.  .  .  . 

Search  me,  O  God,  and  know  my  heart:  try  me,  and 
know  my  thoughts; 

And  see  if  there  be  any  wicked  way  in  me,  and  lead  me 
in  the  way  everlasting. 

And  Francis  Thompson,  in  the  first  stanza  of  his  great 
religious  poem,  "The  Hound  of  Heaven,"  puts  the  same 
thought  no  less  majestically  and  with  peculiar  cogency 
for  our  time,  when  he  says: 

I  fled  Him,  down  the  nights  and  down  the  days; 

I  fled  Him,  down  the  arches  of  the  years; 
I  fled  Him  down  the  labyrinthine  ways 

Of  my  own  mind;  and  in  the  mist  of  tears 
I  hid  from  Him,  and  under  running  laughter. 

Up  vistaed  hopes  I  sped; 

And  shot,  precipited, 
Adown  Titanic  glooms  of  chasmed  fears, 
From  those  strong  Feet  that  followed,  followed  after. 

But  with  unhurrying  chase, 

And  umperturbed  pace, 
Deliberate  speed,  majestic  instancy, 

They  beat — and  a  Voice  beat 

More  instant  than  the  Feet — 
"All  things  betray  thee,  who  betrayest  Me." 


II 


Protestant  Christianity: 

I.  Ambiguity  and  Disaster* 

The  title  of  Section  II  of  this  paper  is  "The  Strange 
Affinity  of  Protestant  Christianity  and  Freudian  Psycho- 
analysis/' which  might  well  serve  as  a  subtitle  for  the 
paper  as  a  whole.  Certainly  the  traditional  precepts  of 
Christianity  are  not  such  as  to  lead  one  to  expect  a  ready 
assimilation  of  Freudian  principles;  yet  such  an  assimila- 
tion, astonishingly  enough,  has  occurred — or,  perhaps 
more  accurately,  is  being  widely  promoted.  The  situation 
is  thus  extremely  perplexing  and  problematic.  Here,  in 
the  present  chapter,  an  effort  is  made  to  understand 
this  situation  in  terms  of  historical  and  cultural  develop- 
ments which  date  back  at  least  to  the  Protestant  Refor- 
mation. It  may,  in  fact,  not  be  too  bold  to  conjecture 
that  the  Reformation,  by  its  deficiencies  and  anomalies, 
actually  produced  psychoanalysis.  If  so,  it  can  be  argued 
with  some  cogency  that  the  only  way  to  extricate  our- 
selves from  the  dead  end  of  Freudianism  {see  Chapter 
10)  is  to  continue  the  Reformation.  As  we  shall  see  in 
the  last  section  of  this  chapter,  there  is  actually  wide- 
spread and  growing  support  for  such  a  program,  which 
will  be  more  fully  elaborated  in  Chapter  12. 

I.   INTRODUCTION 

There  can,  I  believe,  be  no  reasonable  doubt  that  in 
that  area  denoted  by  the  terms  Psychiatry  and  Religion, 
we  are  today  in  a  state  of  crisis.  For  the  past  several 
decades  we  have  been  in  the  habit  of  saying  to  anyone 

*  Delivered  at  North  Park  College  and  Seminary  on  May  2  as 
the  first  of  the  David  Nyvall  Lectures  for  1960;  also  presented, 
earlier,  at  a  meeting  held  in  Los  Angeles,  April  21,  1960,  under 
the  auspices  of  the  Department  of  Pastoral  Care  of  the  Hospi-: 
tal  of  the  Good  Samaritan  and  later,  in  September  as  a  Geehns 
Lecture  at  the  Southern  Baptist  Theological  Seminary,  in 
Louisville,  Kentucky. 

156 


Protestantism:  i.  Ambiguity  and  Disaster        157 

who  is  in  emotional  difficulties,  "You  need  therapy.'^ 
But  now  we  are  realizing  that  our  so-called  therapy  is 
itself  sick  and  needs  ''therapy"  (cf.  Chapter  10).  As 
long  as  we  continue  to  believe  that  all  is  well  in  this 
area  and  that  all  we  need  is  more  of  the  same,  just 
so  long  will  we  continue  to  spiral  downward  in  a  vicious 
circle  which,  as  Richard  LaPiere  (1959),  Huston  Smith 
(1960),  and  others  are  suggesting,  is  bringing  our  very 
civilization  and  established  way  of  life  into  jeopardy. 

Personality  disorder  of  sufficient  severity  to  require 
hospitalization  is  today  commonly  acknowledged  as  the 
nation's  number-one  "health  problem";  and  the  preva- 
lence of  divorce,  delinquency,  suicide,  perversion,  and 
addiction  of  various  kinds — including  the  habitual  use  of 
alcohol,  tobacco,  and  various  other  tranquilizers — ^be- 
speaks the  widespread  tensions  and  poor  personality 
integration  in  the  populace  at  large. 

Religion,  to  which  we  have  traditionally  looked  for 
redemption  from  evil  and  guidance  in  the  good  life  has 
all  but  abandoned  its  claim  to  competence  in  these 
matters.  To  be  sure,  in  recent  decades  there  has  been  an 
attempt,  in  the  guise  of  the  pastoral  counseling  move- 
ment, to  regain  lost  ground;  but  here  the  dominant  ideas 
bave  been  essentially  secular;  and  when  clergymen  them- 
selves have  serious  personality  problems,  they  almost 
invariably  seek  a  secular  therapist  rather  than  depend 
upon  inspiration  and  direction  from  within  their  own 
profession.  On  several  occasions  I  have  made  the  state- 
ment that  contemporary  Protestantism  has  handled  the 
problem  of  personal  guilt  very  poorly;  and  it  is,  1  think, 
tio  accident  that  this  assertion  has  not  been  seriously 
challenged.  For  as  long  as  Protestant  clergymen  preach 
the  Christian  gospel  on  Sundays  and  then,  on  weekdays, 
lave  recourse  to  secular  psychotherapists  for  help  in  the 
management  of  their  own  lives,  their  message  will  have 
ittle  force  or  effect  in  stemming  the  tide  of  personal  and 
social  disorganization  in  our  time.  As  Anton  T.  Boisen 
iDbserved  more  than  30  years  ago,  most  Protestant  reli- 
i;ious  leaders  have  allowed  themselves  to  drift  into  a 
bosition  from  which  they  can  speak  only  as  the  scribes 
pd  Pharisees,  not  with  authenticity  and  authority  (see 
Chapter  6).  They  proclaim  certain  tenets  of  Protestant 


158  The  Crisis  in  Psychiatry  and  Religion 

doctrine,  particularly  of  a  Calvinist  stripe,  from  their 
pulpits,  but  seem  completely  unimpressed  that  this  doc- 
trine is  not  saving  thertiy  much  less  the  persons  to  whom 
they  ostensibly  minister.  They  preach  justification  by 
faith  and  roundly  condemn  "good  works,"  and  seemingly 
take  no  account  of  how  poorly  this  doctrine  itself  works, 
in  the  lives  of  modern  men  and  women. 

In  August,  1956,  a  story  appeared  in  Life  Magazine 
on  "Why  More  and  More  Ministers  Crack  Up,"   ini 
which  the  author  maintained  that  the  trouble  lies  simply 
in  overwork.  Modern  churches,  he  argued,  make  exces-i 
sive  demands  of  their  ministers;  and  the  solution  sug-' 
gested  was  for  all  churches  of  more  than  500  members 
to  have  two  or  more  ministers,  with  a  clearly  defined 
division  of  labor.  While  this  is  no  doubt  a  good  prac- 
tical suggestion,  it  does  not,  I  believe,  get  to  the  root  of 
the  difficulty.  The  trouble  basically  is  that  the  modern 
clergyman  is  in  an  ambiguous  and  agonizing  situation: 
pretending  to  minister  the  Bread  of  Life  to  others  and: 
having  no  deep  trust  in  it  himself. 

Here  the  inconsistency  of  the  clergy  is  equalled  only 
by  the  audacity  of  the  secular  therapists  to  whom  they 
turn,  not  only  for  personal  guidance  but  also  for  intel- 
lectual inspiration  and  enlightenment.  Although  it  has 
been  evident  for  at  least  20  years  that  classical  Freudian 
psychoanalysis  is  a  therapeutic  fiasco,  yet  the  assumptions 
concerning  the  nature  of  man  from  which  this  form  of 
treatment  was  derived  continue  to  be  acclaimed  as  if 
one  could  move  the  world  with  them.  I  don't  know 
how  often,  when  I  have  criticized  psychoanalysis,  the 
protest  has  come  back:  "But  isn't  it  true  that  the  super- 
ego is  overly  severe  in  the  neurotic  individual  and  needs 
to  be  softened,  made  less  harsh  and  demanding?"  It  is? 
true  that  this  is  what  Freud  saidy  and  a  lot  of  people^ 
have  tried  to  believe  and  apply  this  doctrine.  But  it  is 
public  knowledge  that  both  therapy  and  prevention! 
which  are  based  on  this  premise  lead  only  to  the  most 
dismal  consequences;  and  one  might  suppose  it  wast 
time  that  we  stopped,  for  purely  pragmatic  reasons^ 
accepting  the  premise  itself.  If  it  doesn't  work^  what  is 
there  to  make  us  think  it  is  true,  especially  when  it 
contradicts  some  of  the  most  basic  principles  of  the 
Judeo-Christian  ethic? 


Protestantism:  i.  Ambiguity  and  Disaster        159 

ii.  the  strange  affinity 
of  protestant  christianity 
and  freudian  psychoanalysis 

For  a  long  time  it  was  a  mystery  to  me  why  Protes- 
tantism and  Freudian  psychoanalysis  have  hit  it  off  so 
well.  In  many  ways  they  are  very  strange  bedfellows 
indeed.  The  New  Testament,  to  say  nothing  of  the  Old, 
seems  fairly  to  cry  out  in  opposition  to  everything  which 
psychoanalysis  stands  for;  and  Freud,  in  his  book.  The 
Future  of  an  Illusion,  made  his  opposition  to  and  con- 
tempt for  religion  crystal  clear  [cf.  Chapter  9].  Yet 
present-day  Protestantism  and  Freudian  analysis  are  so 
blended  and  interdigitated  that  it  is  hard  to  tell  where 
one  ends  and  the  other  begins. 

The  total  explanation  of  this  astonishing  state  of 
affairs  is,  I  am  sure,  complicated.  But  do  we  not  find 
food  for  thought  in  the  fact  that  both  Protestantism, 
insofar  as  it  is  Calvinistic,  and  the  secular  psychothera- 
peutic enterprise,  insofar  as  it  is  Freudian,  equally  stress 
the  helplessness  of  man?  Calvin  saddled  us  with  the 
doctrine  of  predestination  and  divine  election;  and  Freud 
spoke  of  psychic  determinism  and  the  tyranny  of  the 
unconscious.  Both  would  have  us  believe  that  we  are 
totally  incapable  of  helping  ourselves;  and  they  differ 
principally  in  the  extent  to  which  they  hold  us  account- 
able for  the  distressing  predicaments  in  which  we  com- 
monly find  ourselves. 

Protestantism  has  been  curiously  one-sided  in  its  argu- 
ment on  this  score.  While  holding  that  when  we  behave 
badly  it  is  by  our  own  volition  and  choice,  it  then  insists, 
paradoxically,  that  when  we  behave  well  this  is  by  the 
grace  of  God,  for  which  we  deserve  no  credit.  In  other 
words,  the  doctrine  is  that  when  we  are  confronted  by 
an  apparent  option  of  good  and  evil,  we  can  choose 
only  the  evil,  and  are  fully  accountable  for  having  done 
so;  but  if  we  do  the  good  rather  than  the  evil,  this  is 
because  of  God's  will  and  direction.  In  short,  man  can 
willfully  and  deliberately  act  and  work  himself  into  a 
state  of  perdition;  but  he  cannot,  by  the  reverse  strategy, 
save  or  redeem  himself.  Salvation  comes,  if  it  comes  at 
all,  only  by  the  grace  and  unpredictable  favor  of  God. 


160  The  Crisis  in  Psychiatry  and  Religion 

Small  wonder,  then,  that  such  a  doctrine  leads  to  the 
condition  of  uncertainty  and  ''despair"  about  which  Soren  i 
Kierkegaard  has  written  so  poignantly  in  his  Sickness  \ 
unto  Death  and  Attack  upon  Christendom.  And  it  is,  Ii 
submit,  this  same  despair  that  fostered  the  development! 
and  growth  of  Freudian  psychoanalysis;  for  psychoanalysis  \ 
takes  the  further  step  of  making  man  irresponsible  andi 
unaccountable,  not  only  for  his  salvation,  but  also  for 
his  sins  as  well. 

According  to  Freud  the  neurotic  individual  is  helpless, 
because  certain  of  his  problems  have  been  relegated  toi 
and  lost  within  the  Unconscious  Mind.  But  Freud  was 
at  least  more  consistent  and,  in  one  sense,  more  benign. 
Unlike  Calvin,  he  held  the  individual  accountable  neither 
for  his  salvation  nor  for  his  sin.  As  a  child,  the  individual 
who  is  destined  to  be  neurotic  as  an  adult,  has  sup- 
posedly been  so  harshly  and  unreasonably  treated  by  his 
parents  that  he  has  no  alternative  but  to  repress  certain 
impulses,  certain  instincts;  and  it  is  this  act  of  repression 
or  dissociation  which  lays  the  basis,  according  to  Freud, 
for  that  special  misery  called  neurosis.  Thus  psycho- 
analysis goes  Protestant  theology  one  better  and  makes 
us  not  only  unable  to  help  ourselves  in  the  matter  of 
"'recovery"  but  also  blameless,  and  unaccountable,  for 
having  gotten  ourselves  into  our  "neurotic  predicament* 
in  the  first  place. 

It  is,  therefore,  not  surprising  that  so  many  Protestant 
clergymen,  as  well  as  the  members  of  their  congrega- 
tions, have  flocked  to  secular  psychotherapists  for  "help." 
The  analyst  not  only  gives  a  more  definite  promise  of 
salvation;  he  also  holds  us  less  "to  blame"  for  our  diffi- 
culties. Calvinist  Protestantism  has  said  to  us:  "You  are 
responsible  for  your  sins,  but  you  are  incapable  of  being 
equally  responsible  for  your  redemption.  God  condemns 
you  for  your  evil,  but  He  will  pay  no  attention  to  your 
own  efforts  to  redeem  yourself  and  will  Himself  save 
you  or  not,  according  to  His  inscrutable  pleasure."  This,* 
I  submit,  is  a  psychological  and  human  absurdity  and  a 
Christian  deviation  and  perversity.  But  instead  of  rectify- 
ing this  perversity,  we  have  compounded  it  by  plunging 
into  psychoanalysis,  which  extends  the  heresy  to  its. 
logical  limits  and  takes  away  our  responsibility,  choice^i 


ROTESTANTISM :    I.   AmBIGUITY  AND   DISASTER  161 

id  freedom  not  only  with  respect  to  our  salvation  but 
so  for  our  sin  as  well. 


I.  THE  NEO-ORTHODOXY  OF  THE  NEO-FREUDIANS 

On  other  occasions  I  have  documented  the  statement 
lat  there  is  not  a  shred  of  evidence  that  psychoana- 
zed  individuals  permanently  benefit  from  the  experience 
Chapters  1,  9,  and  14];  and  there  are  equally  clear 
dications  that  psychoanalysis,  as  a  common  philosophy 
'  life,  is  not  only  nontherapeutic  but  actively  pernicious, 
ere  I  shall  not  attempt  to  review  the  objective  evidence 
it  will  speak  instead  about  the  reactions  of  a  psychiatrist 
ith  whom  I  recently  had  considerable  contact  at  a 
lall,  intensive  three-day  conference.  His  position  was, 

effect,  this.  Yes,  he  agreed  that  psychoanalysis  is  un- 
tisfactory.  He  had  been  trained  in  it,  had  applied  it, 
id  could  not  make  it  work  successfully  and  so  had 
landoned  it  for  a  different  form  of  practice,  for  which 
!  had  higher  hopes.  He  could  not,  he  admitted,  prove 

yet  that  his  approach  was  superior  to  that  of  Freud; 
it,  he  said,  "people  keep  coming  to  you  and  you  have 
do  something."  And  what  precisely  was  this  something 
lich  he  was  doing? 

It  turned  out  that  his  deviation  from  Freud  consists 
:gely  in  the  fact  that  he  does  not  require  his  patients 

lie  on  a  couch  and  does  not  observe  certain  other 
-called  "technical  rules"  of  analysis;  but  he  is  still 
vocating  the  basic  Freudian  premise  that  in  neurosis 
/hich  I  hold  is  just  a  medical  euphemism  for  a  state 

unacknowledged  and  unredeemed  real  guilt),  the 
dividual  is  blaming  and  punishing  himself  quite  un- 
cessarily.  As  we  grow  up,  this  psychiatrist  said,  "we 
come  our  own  parents,"  which  was  his  way  of  para- 
irasing  the  Freudian  notion  that  the  conscience  or 
perego  is  an  incorporation  or  introjection  of  our  par- 
ts' standards  and  values.  And  then  he  added,  "We 
ow  the  injustices  to  which  we  were  subjected  back 
ere  in  our  family.  We  know  what  the  atmosphere  in 
r  home  was  like.  And  yet  we  insist  upon  treating  our- 
ives,  as  adults,  in  the  same  harsh  and  unreasonable 
ly  our  parents  treated  us  as  children." 


162?  The  Crisis  in  Psychiatry  and  Religion 

In  insisting  that  our  children  develop  a  sense  of  guil 
and  the  capacity  to  blame  themselves,  we  pave  the  wa 
for  neurosis,  according  to  this  psychiatrist.  And  by  sup 
porting  this  kind  of  child  training,  the  churches,  he  said 
"are  propagating  a  most  vicious  kind  of  mental  ill  healtV, 
The  churches  create  this  type  of  attitude  in  people,  an.] 
I  get  the  sweepings  from  it.  I'm  tired  of  seeing  religiouj 
parents  and  the  churches  teach  children  to  tramp  oi 
themselves  and  would  like  to  see  this  group  take  a; 
official  stand  against  such  practices."  We  are  ''divine, 
the  psychiatrist  argued,  and  we  have  no  right  to  tre£ 
ourselves  in  this  way.  And  he  blamed  religious  institi 
tions  for  teaching  a  doctrine  of  sin,  and  guilt,  and  sel 
condemnation  instead  of  a  doctrine  of  self-love,  sel 
forgiveness,  and  self-acceptance. 

How  unrealistic  can  we  get?  Conscience,  that  is  to  S£ 
the  capacity   for  self-blame   and   self-punishment,   is  ( 
marvelous  human  and  social  invention,  which  has  tl 
highly  adaptive  function   of  causing  us  to  "tramp  c 
ourselves"  in  order  that  others  don't  have  to  do  th 
for   us.   I   know   not   a   single  reputable  sociologist  f 
anthropologist  who  would   seriously   maintain   that  v 
can  have  a  society  which  does  not  internalize,  as  th 
would  say,  the  norms  of  the  culture  (Mowrer,   1961 
Otherwise  we  have,   not  a   society,   not  an   organize 
disciplined,  orderly  group,  but  an  aggregate  of  psych 
paths  or,  more  accurately,  sociopaths.  And  this  is  pi 
cisely   the   direction    in   which    classical   psychoanalyl 
theory  and  treatment  and  the  so-called  psychotherapeul 
enterprise  in  general  have  been  pushing  us  and  the  dire 
tion  in  which  we  are  actually  moving.  Was  it  not  the  ve 
fact  that  the  individuals  involved  in  the  1959  televisi< 
quiz-show  scandals  did  not  "tramp  on  themselves"  th 
permitted  them  to  act  as  they  did?  This  is  only  one] 
dozens   of  similar  illustrations   of  what  happens  whi 
human  beings  refuse  to  "be  their  own  parents"  and 
act  as  responsibly  in  their  adult  life  as  their  parents  tri 
to  teach  them  to  act  as  children. 

As  indicated  in  the  preceding  section  of  this  pap 
Calvinist  Protestantism  took  the  first  major  step  tow£ 
that  brand  of  personal  irresponsibility  which  is  sociopatl 
by  making  us  supposedly  powerless  to  do  anything  C( 
structive  about  our  guilt  and  sin;  and  then  psychoanal}! 


Protestantism:  i.  Ambiguity  and  Disaster        163 

:ame  along  and  took  us  the  rest  of  the  way  by  insisting 
:hat  not  only  can  we  not  help  ourselves  move  toward 
:ecovery;  we  are  wrong  to  blame  or  punish  ourselves  in 
:he  first  place.  We  should  love  and  accept  and  respect 
Durselves  so  perfectly  and  so  completely  and  so  uncondi- 
;ionally  that  we  refuse  to  condemn,  punish,  "tramp  on" 
}urselves,  no  matter  what!  This,  I  submit,  is  not  self- 
respect.  This  is  the  ultimate  in  self-contempt  and  rejec- 
don!  For  it  requires  us  to  regard  ourselves,  not  as  human 
)eings,  but  as  a  variety  of  organism  not  basically  different 
TOm  the  beasts  of  field  and  jungle,  with  no  morality,  no 
itandards,  no  character,  no  spirit.  Who  wants  to  lose  his 
Capacity  to  condemn  and  punish  himself  if  he  really 
pehaves  badly.  This,  surely,  is  the  Pearl  of  Great  Price; 
md  a  so-called  "therapist"  who  would  take  it  from  us 
toes  not  respect  us  but  despises  us,  himself,  and  the 
vhole  human  enterprise.  It  is  true,  of  course,  that  if  we 
lid  not  have  the  capacity  for  self-condemnation  and  self- 
mnishment,  we  would  never  be  neurotic  or  functionally 
jsychotic,  but  neither  can  we  be  human  without  such 
apacity.  As  Boisen  (1936)  has  observed,  susceptibility 
0  this  anguish  is  the  price  we  pay,  the  risk  we  take,  for 
tur  efforts  to  be  something  more  than  vegetables  and 
)easts.  This  is  why  I  have  said  on  other  occasions  [Chap- 
ers  9  and  14]  that  psychoanalysis  is  not  messianic  but 
iemonic,  not  salvation  but  slavery  and  bondage  of  the 
/orst  kind. 


^.   GUILT   IS   THE   GREATEST   EVIL 

Following  a  lecture  which  I  gave  recently  at  the  Uni- 
ersity  of  California  at  Los  Angeles  [March  7,  1960], 
)r.  D.  P.  Boder  made  some  extemporaneous  comments 
hich  I  found  extremely  illuminating  and  which  I  believe 

can  reproduce  almost  verbatim.  He  said: 

The  Freudian  theory  of  emotional  sickness  and  its  treat- 
ment is  a  direct  outgrowth  of  the  writings  of  the  19th-cen- 
tury German  nihilistic  philosophers.  Nietzsche,  particularly 
in  his  book  The  Genealogy  of  Morals,  repeatedly  affirms  that 
guilt  is  a  weakness.  And  the  poet  Schiller,  in  his  play,  The 
Bride  of  Massina,  has  the  chorus  end  the  play  by  speaking 
these  lines: 


164  The  Crisis  in  Psychiatry  ai^  Religion 

Life  may  not  be  the  highest  possession. 

But  guilt  is  the  greatest  evil.  ! 

Since  Protestant  Christianity  instills  in  us  the  capacity 
to  experience  guilt  but  with  no  personal  resource  05 
reliable  possibility  for  alleviating  it,  we  can  see  why  mer: 
of  intelligence  and  vitality  began  to  think  and  utter  such 
outrageous  ideas.  And  Freud,  far  from  saving  us  frorr 
this  rebellion  and  despair,  perfected  and  systematized  it| 
Today  we  are  paying  the  price  for  having  accepted  this 
ideology. 

You  will,  I  hope,  realize  that  here  I  am  speaking  in  j 
highly  generalized  way.  There  are,  perhaps,  a  few  psy 
chotherapists  here  and  there  who  are  practicing  thei 
profession  along  lines  radically  different  from  those  lai( 
down  by  Freud.  But  they  have  not  as  yet  become  ver 
articulate  in  the  professional  literature  and  it  is  hard  t(. 
identify  them.  There  are,  of  course,  plenty  of  therapist 
who  are  purportedly  non-Freudian;  but  the  majority  o 
these,  I  fear,  are  like  the  psychiatrist  whom  I  cited  earlier, 
because  they  have  abandoned  classical  Freudian  tech 
nique  or  some  minor  aspect  of  the  theory,  they  cat 
themselves  non-Freudian,  or  neo-Freudian,  or  perhap 
even  anti-Freudian  while  continuing  to  accept  the  majo 
premises  of  Freud's  philosophy  and  thought. 

The  nondirective  or  client-centered  type  of  therap; 
which  is  associated  with  the  name  of  Carl  Rogers  will 
of  course,  be  immediately  thought  of  by  many  as  "non 
Freudian."  But  as  I  am  here  using  the  term,  I  woulc 
say  that  Roger's  approach  is  deeply  "Freudian"  (cf 
Youngs,  1960).  Like  classical  psychoanalysis,  it  begin 
by  not  holding  the  individual  personally  responsible  fo 
his  difficulties  and  gives  him  no  prescription  for  dealinj 
with  them  on  his  own  initiative.  Rogers  views  the  in 
dividual  as  inherently  good  and  holds  that  he  is  coi 
rupted  and  diverted  from  his  indigenous  growth  ten 
dencies  along  normal  and  healthy  lines  by  the  untowan 
actions  and  attitudes  of  those  around  him.  Here  the  en 
couragement  of  self-pitying  and  hostile  tendencies  withii 
the  client  is  hardly  less  direct  than  it  is  in  psychoanalysis 
And  although  Rogers  (1951)  has  seemed  not  to  accep 
Freud's  doctrine  of  repression,  he  speaks  of  the  ''denia 
of  experience"  which,  operationally,  is  not  easily  differen 


Protestantism:  i.  Ambiguity  and  Disaster        165 

tiated  from  dissociation  or  repression,  thus  re-afErming 
the  doctrine  of  the  Unconscious  and  the  individual's 
essential  helplessness  with  respect  to  it.  I  understand 
from  others  who  have  recently  worked  with  Dr.  Rogers 
that  his  views  are  in  process  of  being  revised;  but  as  of 
his  best  known  and  most  recent  public  utterances,  I 
believe  this  appraisal  is  a  reasonable  and  accurate  one. 

It  can,  of  course,  be  objected  that  my  strictures  against 
Protestantism  are  likewise  not  universally  applicable.  And 
here  the  argument  may  take  either  of  two  directions. 
Some  will  insist  that  I  do  not  understand  what  Calvin 
"really  meant."  Although  I  think  I  have  a  fair  concep- 
tion of  what  Calvin  stood  for  (cf.  Gilkey,  1960),  I  must 
confess  that  I  am  not  greatly  concerned  about  the  under- 
standing of  Calvin  himself.  What  is  important  for  our 
purpose  is  the  widespread  popular  conception  of  what  he 
meant;  and  I  am  therefore  using  "Calvinism"  in  much 
the  same  way  as  I  am  "Freudianism."  I  can  myself  quote 
excerpts  from  Freud's  writings  which  seem  categorically 
to  contradict  the  general  position  here  (and  popularly) 
attributed  to  him.  But  the  important  thing  is  the  main 
thrust  and  impact  of  the  thought  of  these  men;  and  if 
this  does  not  in  all  details  correspond  to  precisely  what 
they  said  (especially  toward  the  latter  periods  of  their 
lives,  when  they  had  had  a  chance  to  reconsider  a  bit), 
this  does  not  particularly  matter.  We  are  concerned  here 
ivith  cultural  forces,  and  the  very  fact  that  I  have  chosen 
to  deal  with  both  Freudianism  and  Calvinism  as  they  are 
bopularly  understood  is  consistent  with  this  aim  and  goal. 

The  second  of  the  two  types  of  objection  referred  to 
I  moment  ago  is  this,  namely,  there  are  certain  Funda- 
nentalist  or  "sect"  groups  within  the  Protestant  spectrum 
vho  have  not  "fallen"  for  Freudianism  to  the  extent  that 
iberal  Protestantism  has.  This  I  readily  grant;  but  at 
3nce  we  have  to  make  a  distinction  between  those  groups 
vhich  are  explicitly  Calvinistic  and  those  which  are 
iecidedly  not.  The  Calvinistic  sect  groups  are  in  much 
he  same  position  as  was  Protestantism  in  general  before 
he  advent  of  liberalism  and  the  infiltration  of  Freudian- 
sm.  They  leave  man  with  his  guilt  and  do  not  attempt 
:o  deliver  him  from  his  "despair"  by  the  Freudian  for- 
mula of  making  him  not  only  helpless  but  also  blameless, 
pliey  are  thus,  in  one  sense  at  least,  in  a  sounder  posi- 


166  The  Crisis  in  Psychiatry  and  Religion 

tion  than  are  the  hberal  Protestant  groups  and  have,  one 
may  say,  less  to  repent.  But  they  are  still  on  the  horns; 
of  the  dilemma  which  Calvinism  itself  poses  and  do  not 
offer  a  satisfactory  resting  place.  ! 

In  contrast,  there  are  some  so-called  sect  groups  whichi 
preach  and  practice  a  form  of  Christian  doctrine  whichi 
seems  to  me  remarkably  close  to  primitive  Christianity 
and  which  has  been  remarkably  little  affected  by  the 
more  dubious  aspects  of  the  Reformation,  Later  we  shall) 
have  occasion  to  look  again,  more  closely,  at  these  groups,i 
at  the  same  time  that  we  also  consider  the  place  ofi 
Roman  Catholicism  and  Judaism  in  the  modern  world? 
[Chapter  12].  First,  however,  it  will  be  necessary  toi 
review  certain  other  considerations  of  a  somewhat  differ-* 
ent  nature. 

V.    SECULARIZATION   AND   CRISIS  ' 

Before  one  can  have  anything  like  an  adequate  under-: 
standing  of  the  present  crisis  in  psychiatry  and  religion,! 
one  must,  I  believe,  carefully  note  the  extent  to  which 
numerous  functions  which  prior  to  the  Reformation  were 
regarded  as  the  proper  concern  of  the  Church  have 
today  been  secularized.  The  Reformation  was  a  valiant 
effort  to  free  mankind  from  the  oppressive  control  and 
domination  previously  exercised  by  the  Church  Universal. 
And  separation  of  Church  and  State,  in  as  many  areas- 
as  possible,  was  seen  as  basic  to  this  enterprise. 

Separation  of  Church  and  State  in  the  area  of  politics 
was,  of  course,  a  prime  objective  of  the  Reformation;  and 
we  still  have  a  strong  feeling  that  religious  groups  should 
"stay  out"  of  politics,  at  least  in  the  formal  sense  of  the 
term.  Education  has  likewise  been  extensively  secularized. 
Our  public  schools  are  testimony  to  the  success  of  this 
movement,  even  though  there  is  still  resistance  in  some 
quarters,  both  in  theory  and  practice.  The  trend  toward 
secularization  has  also  been  marked  in  the  area  of  charity. 
Here  we  note  the  widespread  development  of  public 
relief,  as  well  as  numerous  welfare  agencies  of  a  private 
but,  again,  largly  secular  nature.  The  introduction  of 
insurance  of  various  kinds  has  had  a  similar  effect  in  this 
connection:  now,  instead  of  giving  directly  to  persons 
who  have  suffered  physical  calamity,  such  as  loss  oi 


Protestantism:  i.  Ambiguity  and  Disaster        167 

lome  by  fire  or  flood,  or  incapacitating  illness  or  death 
n  their  family,  we  pay  regular  ''premiums"  to  a  company 
vhich  carries  out  these  functions,  quite  automatically 
md  impersonally,  for  us. 

In  these  areas,  then — of  politics,  education,  and  charity 
—it  looks  as  if  separation  of  church  and  state,  in  some 
legree  at  least,  is  here  to  stay.  We  shall  later  [Chapter 
[2]  have  occasion  to  examine  some  of  the  less  fortunate 
consequences  of  the  secularization  of  charity;  and  there 
ire  also  those  who  point  to  evils  that  arise  in  public 
education.  But,  by  and  large,  the  gains  seem  to  exceed 
he  losses — at  least  this  is  the  way  the  situation  is  popu- 
arly  perceived;  and  there  is  no  strong  inclination  for  our 
ociety  as  a  whole  to  revert  to  the  earlier  condition  of 
;hurch  control  in  these  areas. 

There  is,  however,  another  area  in  which  secularization 
las  occurred,  with  results  which  are  far  from  satisfactory 
)r  reassuring.  I  refer  to  the  management  of  the  problem 
)f  personal  guilt.  Traditionally  the  solution  to  this  prob- 
em  has  rested  very  largely  in  the  hands  of  the  church; 
md  although  Protestant  and  Catholic  leaders  alike  con- 
inue  to  lay  claim  to  interest  and  competence  in  this 
irea,  the  fact  is  that  those  persons  who  are  most  deeply 
)urdened  and  broken  by  guilt  and  moral  failure  are  now 
[uite  regularly  turned  over  by  the  churches  to  the  state 
or  "care  and  treatment."  This  statement,  to  be  sure, 
nvolves  an  assumption,  namely,  that  in  so-called  men- 
al  illness  or  psychopathology  the  central  problem  is 
;uilt,  unconfessed  and  unatoned  real  guilt;  but  elsewhere 
Chapters  3,  4,  5,  7,  8,  10,  14]  I  have  assembled  so  much 
evidence  for  believing  this  assumption  to  be  justified 
hat  here  I  propose  to  take  it  for  granted.  On  other 
)ccasions  [Chapters  9  and  10]  I  have  also  cited  extensive 
ividence  for  the  assertion  that  the  state  mental  hospital, 
\s  a  therapeutic  agency,  is  a  failure  and  that  the  time 
b  upon  us  for  re-thinking  the  whole  attempt  to  help  guilt- 
idden  persons  in  a  secular,  medically  controlled  setting. 
I  The  phenomenon  of  legal  guilt  is  manifestly  a  state 
|esponsibility  and  probably  should  remain  so,  at  least 
nsofar  as  the  determination  of  responsibility  for  specific 
-Cts  is  concerned.  But  here  again  there  is  question  as  to 
he  success  of  the  state's  efforts  at  treatment  and  rehabili- 
ation.  Legally,  retribution  is  the  principal  instrument  of 


168  The  Crisis  in  Psychiatry  and  Religion 

''justice,"  and  as  a  deterrent  to  crime  on  the  part  of 
others,  it  may  be  quite  essential;  but  there  is  widespread' 
disillusionment  regarding  its  redemptive  powers,  and, 
such  writers  as  Albert  Eglash  (1958,  1959)  are  now  sugi 
gesting  that  prison  programs  ought  to  proceed  muchi 
more  along  lines  of  restitution  rather  than  retribution.| 

It  appears,  then,  that  secular,  state-directed  efforts  tc; 
rehabilitate  guilty  people — ^both  those  who  have  been, 
legally  adjudged  guilty  (i.e.,  criminals)  and  those  who 
(as  Boisen  has  said)  are  seZ/-condemned  (i.e.,  the  insane) 
— ^leave  much  to  be  desired.  In  both  areas  there  has 
been  a  widespread  attempt,  particularly  under  medical 
aegis,  to  eliminate  the  whole  notion  of  moral  involve- 
ment and  to  treat  both  groups  as  if  they  were  sick.  The 
result  is  that  we  are  now  beginning  to  talk  about  our 
whole  society  being  "sick,"  and  I  have  elsewhere  sug- 
gested [Chapter  10]  that  the  essence  of  this  "sickness" 
is  the  undue  extension  into  these  areas  of  the  sickness 
concept  itself. 

But  there  is  another  side  of  this  problem  which  is  quite 
as  important  as  the  one  we  have  just  been  considering. 
Religion,  as  an  institution,  can  very  possibly  survive 
without  having  a  direct  role  in  politics,  or  in  education, 
or  perhaps  even  in  charity  in  the  material  sense  of  that 
term;  but  there  is  grave  question  as  to  whether  religion 
can  survive,  i.e.,  remain  vital  and  meaningful,  if  it  simi- 
larly relinquishes  its  responsibility  for  ministering  to  those 
who  are  devastated  by  personal  guilt.  I  have  previously 
argued  [Chapters  6,  7,  8],  as  Anton  Boisen  has  done 
for  the  past  thirty-five  years,  that  the  church  loses  its 
very  excuse  for  existence  and  cuts  itself  off  from  essential 
sources  of  inspiration  and  validation  as  soon  as  it  refuses 
to  go  "all  the  way"  with  the  person  who  is  in  that  emo- 
tional and  moral  crisis  which  we  call  neurosis  and  psycho- 
sis. As  soon  as  the  church  turns  such  a  person  over  to 
some  other  agency  or  profession  to  deal  with,  it  signs 
and  seals  its  own  death  warrant. 

This  view  of  the  situation  was  brought  home  to  me 
with  special  cogency  and  force  recently  when  I  heard 
a  young  minister  use  a  purely  hypothetical  human  situa- 
tion to  illustrate  a  point  in  theology,  in  a  group  where 
a  psychiatrist  who  was  present  was  promptly  able  to  cite 
a  real,  flesh-and-blood  "case"  to  the  contrary.  Boisen  has 


Protestantism:  i.  Ambiguity  and  Disaster        169 

long  pleaded  with  ministers  and  theologians  to  put  their 
books  away  for  a  season  and  to  study  those  ''human  docu- 
ments" one  finds  in  what  he  also  colorfully  calls  "the 
wilderness  of  the  lost."  This  is  not  a  great  innovation  or 
departure  for  Judeo-Christianity;  instead  it  is  a  challenge 
to  the  churches  to  return  to  a  depth  of  ministry  which 
they  have  generally  abandoned.  In  the  parable  of  the 
lost  sheep,  Christ  tells  of  the  good  shepherd  leaving  the 
ninety  and  nine  that  are  safely  in  the  fold  and  going 
to  look  for  the  one  that  has  gone  astray  (Matt.  18:10). 
Is  it  not  the  very  fact  that  the  modern  church  has  become 
indifferent  to  lost  souls  that  has  reduced  its  vitality  and 
authenticity  almost  to  the  vanishing  point?  As  long  as 
ministers,  priests,  and  rabbis  are  impelled  and  compelled 
to  "refer"  and  defer  to  psychologists  and  psychiatrists 
when  members  of  their  congregations  meet  severe  per- 
sonal crises,  just  so  long  will  they  find  themselves  in  the 
predicaments  described  earlier  in  this  paper. 

Recently  a  college  student,  in  a  group  where  this 
matter  was  under  discussion,  epitomized  the  situation 
admirably  as  follows.  She  said:  "Because  the  church  has 
refused  to  go  after  the  one  lost  sheep,  we  now  find  that 
we  are  all  'lost,'  confused,  neurotic." 

VI.   SHADOW  OR   SUBSTANCE? 

I  cannot  claim  to  be  at  all  fully  informed  regarding 
contemporary  trends  in  Protestant  theology,  but  my  cas- 
ual impression  here  is  of  a  land  of  shifting  sands.  Vogues 
and  fashions  there  are  in  abundance,  but  I  fail  to  see 
anything  that  looks  much  like  the  bedrock  of  perduring 
human  realities.  One  writer,  by  unusual  eloquence,  force, 
or  novelty,  will  gain  a  following,  only  to  be  superseded 
by  someone  else  who  outdoes  him  at  his  own  tricks.  Just 
at  the  moment  Professor  Paul  Tillich  is  in  the  limelight. 
I  am  not  competent  to  judge  much  of  what  he  has 
written;  but  in  the  one  area  where  I  have  some  claim  to 
specialized  knowledge  I  find  him  thoroughly  ambiguous. 
Take,  for  example,  this  passage  from  a  recent  sermon 
entitled  "The  Good  I  Will,  I  Do  Not": 

In  pulpits,  Sunday  schools  and  families,  Christians  have 
called  sinful  the  natural  strivings  of  the  living,  growing  and 
self-propagating  body.  They  concentrate  in  an  inordinate, 


170  The  Crisis  in  Psychiatry  and  Religion 

purely  pagan  way  on  the  sexual  differentiation  of  all  life  and 
its  possible  distortions.  Certainly,  these  distortions  are  as  real 
as  the  distortions  of  our  spiritual  life,  for  instance,  pride  and 
indifference.  But  it  is  itself  a  distortion  if  the  power  of  Sin 
is  seen  in  the  sexual  power  of  life  as  such.  In  this  way,  such 
preaching  completely  misses  the  image  of  Sin  as  Paul  depicted 
it.  What  is  worse,  it  produces  in  countless  persons  a  distorted 
guilt  feeling  which  drives  from  doubt  to  anxiety,  and  from 
anxiety  to  despair,  and  from  despair  to  the  escape  into  mental 
illness  and  the  desire  to  destroy  oneself  (p.  22). 

What,  precisely,  is  Tillich  saying  here?  As  is  so  typical 
of  many  of  his  writings,  this  passage  contains  a  number 
of  vague  allusions  and  obscurities.  But  what  Tillich  seems 
to  be  saying  here,  and  over  and  over  again  in  many  other 
places,  is  this:  The  Protestant  church  has  given  us  an 
acute  capacity  to  feel  guilt,  quite  unrealistically,  with  no 
adequate  means  of  resolving  it.  Therefore,  with  the  Freu- 
dians, he  is  suggesting  that  we  reject  guilt  at  its  source 
and  thus  not  have  to  deal  with  it.  Guilt,  much  of  it 
religiously  inspired,  he  says,  with  Kierkegaard,  Neitzsche, 
Schiller,  and  Freud,  is  our  sickness.  In  a  recent  letter 
to  a  mutual  friend,  another  distinguished  seminary  pro- 
fessor takes  a  very  different  point  of  view.  He  says:  "In 
so  far  as  Christians  have  fallen  for  the  notion  that  guilt 
is  a  sickness  they  have  made  theological  donkeys  of  them- 
selves. Much  as  I  love  and  respect  [Harry  Emerson]  Fos- 
dick,  I  suspect  he  and  others  of  his  persuasion  got  them- 
selves quite  mixed  up  about  *sin.'  '* 

Here,  surely,  is  a  hopeful  note,  but  it  is  not  in  the 
ascendancy  today.  It  is  not  the  vogue  of  the  moment. 
Today  there  are  literally  thousands  of  ministers  who  are 
under  the  spell  of  Tillich,  Fosdick,  and  the  other  Freu- 
dian apologists.  And  what  is  the  basis  on  which  ministers 
accept  the  leadership  of  such  men?  Is  it  because  psycho- 
analysis has  been  empirically  validated?  Not  in  the  least. 
It  is  rather  because  theology,  by  becoming  bookish  and 
unredemptive,  has  lost  its  true  center  of  gravity,  its  con- 
tact with  basic  human  realities,  and  its  leaders  bob  about 
like  loose  corks  in  a  choppy  sea.  They  turn  to  Freud 
because  they  have  lost  their  own  integrity  and  anchorage. 
If  religious  leaders  had  been  deeply  involved  in  the  care 
and  redemption  of  seriously  disturbed  persons  for  the 
past  century,  instead  of  systematically  "referring"  such 


Protestantism:  i.  Ambiguity  and  Disaster        171 

persons,  there  would  have  been  no  Freud  and  no  neces- 
sity for  a  Tilhch  or  a  Fosdick  to  try  to  legitimize  him! 

Recently,  at  the  conference  to  which  I  have  previously 
alluded,  I  heard  seminar  professors  and  distinguished 
parish  ministers  make  statements  such  as  these:  ''Today 
pulpit  theology  is  a  bunch  of  words."  ''Theology  comes 
between  us  and  people."  "The  minister  has  trouble  get- 
ting his  person  and  his  profession  together."  "The  church 
must  find  a  new  form  for  its  message." 

I  submit  that  the  prime  reason  for  this  distressing  state 
of  affairs  is  the  fact  that  theology,  i.e.,  the  science  and 
art  in  which  many  of  our  ministers  are  trained,  is  un- 
disciplined verbiage.  By  what  operations  is  it  validated, 
tested,  refined,  clarified?  What  are  the  canons  of  evi- 
dence which  a  minister  uses  for  deciding  what  to  preach 
or  write  about?  What  are  the  rules  according  to  which 
he  decides  what  is  truth  and  what  is  error?  Granted  that 
this  is  at  best  a  difficult  area  in  which  to  be  wise,  the 
minister  who  merely  reads,  preaches,  and  perhaps  does 
a  little  pastoral  counseling  with  carefully  selected  cases 
can  hardly  be  expected  to  have  deep  insights  and  to 
inspire  great  confidence. 

Challenge  a  parish  minister  or  seminary  professor  to 
stay  with,  rather  than  "refer,"  a  person  suffering  from  a 
severe  personality  crisis,  and  what  is  the  typical  rejoinder: 
"But  Fm  not  qualified  for  that  sort  of  thing!"  The  fact 
is,  such  a  minister  is  not  qualified.  Because  the  church 
does  not  concern  itself  with  the  one  genuinely  lost  sheep, 
the  whole  congregation  is  eventually  lost;  and  the  min- 
ister himself  goes  into  "therapy"  with  the  same  would-be 
secular  healers  to  whom  he  has  been  referring  others. 
Today's  clergyman  can,  I  maintain,  save  himself  only  by 
the  radical  expedient  of  returning  to  the  full-fledged 
business  of  saving,  rescuing,  redeeming  others.  And  when 
he  does  this,  pulpit  "theology"  will  recover  the  substance 
and  stability  which  are  today  so  conspicuously  lacking. 
Here  is  one  function  which  cannot  be  secularized,  with- 
out calamity  to  all  concerned. 

VII.   THE   REFORMATION   MUST   GO   ON 

Ladies  and  Gentlemen,  I  must  acknowledge  at  this 
juncture  the  surprise  and,  indeed,  embarrassment  I  feel 


172  The  Crisis  in  Psychiatry  and  Religion 

at  finding  myself,  as  a  psychologist,  playing  the  role  of 
theological  and  religious  analyst  and  critic.  The  presump- 
tion thus  involved  is,  of  course,  enormous;  and  I  venture 
upon  such  a  course  only  after  having  become  persuaded 
that  the  contemporary  psychotherapeutic  enterprise,  and 
its  vagaries,  cannot  be  understood  without  examining  the 
theological  situation,  in  both  its  contemporary  and  his- 
torical dimensions.  Even  so,  if  there  were  absolutely  no 
precedent  among  more  competent  scholars  for  the  type 
of  reservations  and  concerns  I  am  expressing,  I  might 
still  lack  the  necessary  audacity  to  enter  into  such  a 
discussion.  But  the  fact  is,  one  finds  considerable  support 
for  this  sort  of  thinking  in  the  works  of  some  of  the  most 
distinguished  theological  writers  of  this  generation. 

In  February  of  1960,  it  was  my  privilege  to  hear  the 
lectures,  on  "The  Christian  Faith  and  Historical  Think- 
ing," which  Dr.  Wilhelm  Pauck,  Professor  of  Church 
History   at   Union   Theological   Seminary,   gave   at   the  I 
Pastoral  Conference  sponsored  by  the  Pacific  School  of  i 
Religion,  in  Berkeley,  California.  Here  Dr.  Pauck  re-i 
minded  his  audience  that  the  leaders  of  the  Reformation  ■ 
were  of  a  decidedly  medieval  stamp  of  mind,  and  that; 
their  insights  and  truths  are  not  necessarily  pertinent  or 
applicable  in  our  time.  He  pointed  out  that  as  a  result  of 
this  hiatus,  "Christianity  has  become  a  minority  move-j 
ment"  in  the  modern  world  and  stoutly  maintained  that ! 
"The  Reformation  must  go  on."  i 

Almost  immediately  afterward,  in  the  Christian  Ccn-j 
tury  for  March  2,  Professor  H.  Richard  Niebuhr,  of  the  i 
Yale  Divinity  School,  published  an  article  entitled,  "Ref-  j 
ormation:  Continuing  Imperative."  The  first  part  of  i 
this  paper  is  largely  autobiographical  and  not  particularly ' 
pertinent  to  our  interests;  but  the  later  part  is  highly  so  i 
and  will  be  quoted  at  some  length. 

My  primary  purpose  today  is  not  to  protest.  It  is  still 
that  of  the  reformation  of  the  church.  I  still  believe  that  I 
reformation  is  a  permanent  movement,  that  metanoia  is  the  | 
continuous  demand  made  on  us  in  historical  life.  The  im- 1 
mediate  reformation  of  the  church  that  I  pray  for,  look  for  j 
and  want  to  work  for  in  the  time  that  may  remain  to  me 
is  its  reformation  not  now  by  separation  from  the  world  but 
by  a  new  entrance  into  it  without  conformity  to  it.  I  believe 
our  separation  has  gone  far  enough  and  that  now  we  must 


Protestantism:  i.  Ambiguity  and  Disaster        173 

find  new  ways  of  doing  what  we  were  created  to  do.  One  side 
of  the  situation  is  that  represented  by  the  "world"  today,  at 
least  the  Western  world.  It  seems  to  me  that  in  that  world 
men  have  become  deeply  disillusioned  about  themselves  and 
are  becoming  disillusioned  about  their  idols — the  nations, 
the  spirit  of  technological  civilization  and  so  on.  They  no 
longer  expect  the  powers  in  them  or  around  them  to  save 
them  from  destruction  (whether  through  holocaust  or  bore- 
dom) or  from  the  trivialization  of  an  existence  that  might 
as  well  not  have  been.  The  so-called  underdeveloped  nations 
— including  Russia — do  not  yet  know  that  there  is  no  hope 
and  no  glory  and  no  joy  in  the  multiplications  of  our  powers 
over  nature,  and  we  have  no  way  of  saving  them  from  going 
through  the  experience  through  which  we  have  passed  or  are 
passing.  But  in  the  West  the  most  sensitive,  if  not  yet  most, 
men  are  living  in  a  great  religious  void;  their  half-gods  have 
gone  and  the  gods  have  not  arrived.  The  religious  revival  we 
are  said  to  have  had  in  recent  years  has  been,  so  far  as  I  can 
see,  less  a  revival  of  faith  in  God  and  of  the  hope  of  glory 
than  a  revival  of  desire  for  faith  and  of  a  hope  for  hope. 
And  it  further  seems  to  me  that  our  churches  have  been  filled 
(our  seminaries  too)  with  men  and  women  who  are  experi- 
encing that  emptiness;  further,  that  there  is  in  the  society  at 
large  a  host  of  similarly  minded  persons  who  have  not  even 
considered  the  church  as  possibly  ministering  to  their  need. 
I  am  haunted  in  the  presence  of  that  situation  by  the  phrase: 
*'the  hungry  sheep  look  up  and  are  not  fed"  (p.  250). 

Professor  Niebuhr  then  calls  for  a  "resymbolization 
of  the  message  and  the  life  of  faith  in  the  One  God" 
and  concludes  by  saying: 

I  do  not  know  how  this  resymbolization  in  pregnant  words 
and  in  symbolic  deeds  (like  the  new  words  of  the  Reforma- 
tion and  the  Puritan  movement  and  the  Great  Awakening, 
like  the  symbolic  deeds  of  the  Franciscans  and  the  social 
gospelers)  will  come  about.  I  do  count  on  the  Holy  Spirit 
and  I  believe  that  the  words  and  the  deeds  will  come  about. 
I  also  believe,  with  both  the  prophets  and,  of  all  men,  Karl 
Marx,  that  the  reformation  of  religion  is  the  fundamental 
reformation  of  society.  And  I  believe  that  nothing  very  im- 
portant for  mankind  will  happen  as  a  result  of  our  "conquest" 
of  space  or  as  a  result  of  the  cessation  of  the  cold  war  unless 
the  human  spirit  is  revived  within  itself  (p.  251). 

Such  statements  as  those  just  quoted  from  Niebuhr 
and  Pauck  not  only  underscore  the  general  shakiness  of 
contemporary  theology;  they  are  also  an  open  invitation 


174  The  Crisis  in  Psychiatry  and  Religion 

to  rethink  our  most  fundamental  presuppositions.  But 
they  do  not  give  us  any  very  confident  or  clear  indication 
of  the  direction  such  thinking  should  take.  Turning  to 
Tillich's  book,  The  Protestant  Era,  a  collection  of  essays 
first  issued  in  1948  and  reissued,  in  abridged  form,  in 
1957,  one  finds  little  help  in  the  earlier  chapters;  but 
the  book  ends  with  a  paper,  initially  published  in  1939 
in  the  American  Journal  of  Sociology  and  entitled,  'The 
End  of  the  Protestant  Era?"  which  is  hard-hitting,  direct, 
and — up  to  a  point — illuminating.  The  argument  begins 
thus: 

The  central  principle  of  Protestantism  is  the  doctrine  of 
justification  by  grace  alone,  which  means  that  no  individual 
and  no  human  group  can  claim  a  divine  dignity  for  its  moral 
achievements,  for  its  sacramental  power,  for  its  sanctity,  or 
for  its  doctrine.  If,  consciously  or  unconsciously,  they  make 
such  a  claim,  Protestantism  requires  that  they  be  challenged 
by  the  prophetic  protest,  which  gives  God  alone  absoluteness 
and  sanctity  and  denies  every  claim  of  human  pride.  This 
protest  against  itself  on  the  basis  of  an  experience  of  God's 
majesty  constitutes  the  Protestant  principle.  This  principle 
holds  for  Lutheranism  as  well  as  for  Calvinism  and  even  for 
modern  Protestant  denominationalism.  It  is  the  principle 
which  made  the  accidental  name  "Protestant"  an  essential 
and  symbolic  name  (p.  226). 

And  then  Tillich  says: 

The  consequences  of  the  Protestant  principle  for  intellec- 
tual, moral,  and  social  life  are  obvious.  Protestantism  is  a 
highly  intellectualized  religion.  The  minister's  gown  of  today 
is  the  professor's  gown  of  the  Middle  Ages,  symbolizing  the 
fact  that  the  theological  faculties  as  the  interpreters  of  the 
Bible  became  the  ultimate  authority  in  the  Protestant 
churches.  But  professors  are  intellectual  authorities — i.e., 
authorities  by  virtue  of  skill  in  logical  and  scientific  argu- 
ment. This  sort  of  authority  is  the  exact  opposite  of  the 
kind  that  is  sought  by  the  disintegrated  masses,  whose  dis- 
integration is  to  some  extent  an  echo  of  the  endless  argu- 
ments and  counterarguments  among  their  leaders.  Bishops, 
priests,  and  monarchs  have  a  sacramental  authority  which 
cannot  be  taken  away  by  arguments  and  which  is  independ- 
ent of  the  intellectual  and  moral  qualities  of  its  carriers.  It 
is  a  character  which  can  by  no  means  be  lost.  This  sacra- 
mental basis  is  denied  by  the  Protestant  protest.  The  minister 
is  preacher,  not  priest;  and  sermons  are  intended,  first  of  all, 
to  appeal  to   the  intellect.  But  the  masses  that  are  dis- 


Protestantism:  i.  Ambiguity  and  Disaster        175 

integrated  need  symbols  that  are  immediately  understand- 
able without  the  mediation  of  intellect.  They  need  sacred 
objectivities  beyond  the  subjective  quality  of  a  preacher.  .  .  . 
More  and  more  individuals  become  unable  to  endure  the 
tremendous  responsibility  of  permanently  having  to  decide  in 
intellectual  and  moral  issues.  The  weight  of  this  responsibil- 
ity became  so  heavy  that  they  could  not  endure  it;  and  men- 
tal diseases  have  become  epidemic  in  the  United  States  as 
well  as  in  Europe.  In  this  situation,  psychoanalysis  has 
seemed  more  desirable  for  educated  people  than  religion, 
especially  Protestant  religion.  In  Catholic  countries  the  situa- 
tion has  been  different  because  the  confession  has  been  able 
to  overcome  many  tendencies  toward  personal  disintegration 
(pp.  227-228). 

Then,  in  a  footnote,  Tillich  refers  to  the  "success  of 
psychoanalysis  in  Protestant  countries"  which  he  at- 
tributes to  the  assistance  it  gives  the  individual  to  ''bear 
responsibility  and  guilt  without  the  help  of  confession 
and  the  related  forgiveness  which  comes  from  the  out- 
side" (p.  228) .  Here,  it  would  seem,  is  where  Paul  Tillich 
took  the  wrong  turn  in  the  road.  Today  we  can  say, 
without  fear  of  contradiction,  that  psychoanalysis  has  not 
been  a  "success,"  in  this  or  any  other  country.  Yet  many 
theologians,  including  Tillich,  continue  to  preach  and 
write  as  if  Freudian  theory  and  practice  were  the  Alpha 
and  Omega.  When,  as  in  the  Tillich  sermon  cited  in  the 
preceding  section,  theologians  today  expound  the  psycho- 
analytic doctrine  of  false  guilt,  they  simply  do  not,  from 
a  secular  and  scientific  point  of  view,  know  what  they 
are  talking  about.  This,  among  other  reasons,  is  why  I 
say  that  secular  students  of  this  problem  have  no  choice, 
at  the  moment,  but  to  strike  out  on  their  own  in  this 
domain  and  make  the  best  sense  of  it  they  can.  And  the 
only  way  the  present  writer  can  understand  the  situation 
is  along  lines  suggested  at  the  outset  of  this  paper, 
namely,  in  terms  of  the  absurdity  of  the  Reformation 
doctrine  of  human  guilt  and  divine  grace.  This,  as  I  have 
already  argued,  places  man  in  an  intolerable  predicament, 
from  which  psychoanalysis  purportedly  rescues  him  but, 
in  point  of  fact,  only  plunges  him  into  the  deeper.  The 
time  has  come,  if  we  are  not  to  march  straight  to  perdi- 
tion, to  make  an  about-face  and  return  to  principles 
which  a  perilous  and  arrogant  theology  has  led  us  to 
ignore  and  despise. 


12 


Protestant  Qiristianity: 

II.  Challenge  and  Change* 

If,  as  the  last  section  of  the  preceding  chapter  suggests, 
the  Protestant  Reformation  was,  in  certain  important 
respects,  deviant  and  incomplete,  there  is  urgent  necessity 
for  continued  exploration,  new  insights,  and  social  in- 
ventiveness.  But  in  an  area  as  intricate  and  vital  as  the 
one  presently  under  consideration,  ^'research" — in  the 
conventional  sense  of  that  term — is  not  very  meaningful. 
What  is  needed,  instead,  is  broad  trial  and  error,  actual 
experience,  or  * 'action  research''  as  it  is  sometimes  called. 
In  the  present  chapter  we  review  *' experiments''  of  this 
type  that  are  already  under  way  and  suggest  certain  other 
possibilities  that  deserve  a  hard  try. 

Surely  one  of  the  main  reasons  why,  as  Pauck  (Chapter 
11)  says,  the  Reformation  ''must  go  on"  is  the  need  to 
bring  science  and  religion  into  a  common,  or  at  least 
cornpatible,  universe  of  discourse.  There  is  at  present 
some  lack  of  sanguinity  on  this  score,  borne  of  the 
consequences — already  apparent  to  many — of  our  having 
tried  to  make  religion  mesh  with  the  pseudoscience  of 
Freudian  psychoanalysis.  We  are  now  in  process  of  get- 
ting a  clearer  vision  of  psychological  and  social  realities; 
but  Reformation  theology  has  made  its  own  distinctive 
contributions  to  present  confusion  and  has  an  obligation 
to  put  its  house  in  order,  as  well.  To  repeat  a  truism,  a 
sound  psychology  and  a  sound  theology  will  show  con- 
gruence, not  conflict,  and  should  generate  personal  prac- 
tices and  institutional  forms  decidedly  superior  to  those 
we  currently  follow. 

In  this  lecture  I  shall  make  no  systematic  attempt  to 
summarize  the  preceding  one  but  will,  instead,  go  directly 

*  Delivered,  in  somewhat  abbreviated  form,  at  North  Park 
College  and  Seminary  on  May  3  as  Part  II  of  the  David  Nyvall 
Lectures  for  1960  and  also  presented,  as  a  Geehns  Lecture,  at 
the  Southern  Baptist  Theological  Seminary. 

176 


Protestantism:  ii.  Challenge  and  Change        177 

on  with  the  main  argument  and  analysis.  However,  I 
shall  try  to  do  this  in  such  a  way  that  those  who  may 
not  have  heard  the  first  lecture  will,  by  inference,  quickly 
identify  the  assumptions  on  which  we  are  operating  and 
the  objectives  toward  which  we  are  aiming. 

I.   FALSE   QUESTS   FOR   IDENTITY  AND   INTEGRITY 

In  the  first  lecture  I  mentioned  having  attended,  a 
few  months  ago,  a  very  remarkable  three-day  conference. 
The  group  consisted  of  ten  or  twelve  eminent  seminary 
professors  and  parish  ministers,  with  a  sprinkling  of 
psychologists  and  psychiatrists.  And  although  I  thought 
I  knew  something  of  the  specialized,  as  well  as  common, 
language  of  the  professions  thus  represented,  by  the  end 
of  the  first  day  I  was  thoroughly  mystified  by  what  was 
being  said  and  done,  especially  by  the  theologians.  Ob- 
viously some  new  type  of  "group  dynamics"  was  at  work, 
which  I  did  not  at  all  understand — or,  I  confess,  like.  We 
had  been  called  together  (and  were  being  paidl)  to 
consider  ways  and  means  whereby  the  modern  church 
can  become  more  intelligent  and  effective  in  helping 
modern  men  and  women  live  confidently,  meaningfully, 
and  creatively  (in  the  best  sense  of  that  vastly  over- 
worked term).  But  this  group  was  obsessed  by  a  cultus 
which  was  foreign  to  me  personally  and,  as  I  perceived 
it,  irrelevant  and  negative  as  far  as  the  stated  objectives 
of  the  meeting  itself  was  concerned. 

By  the  end  of  the  second  day,  with  everyone  picking 
at  and  on  everyone  else,  as  well  as  himself,  and  generat- 
ing an  impenetrable  intellectual  and  emotional  fog,  a 
little  light  began  to  dawn.  Here,  I  surmised,  were  the 
Existentialism  of  Paul  Tillich  and  the  I-Thou  philosophy 
of  Martin  Buber  in  action.  My  fellow  conferees  were,  it 
seemed,  trying  to  put  into  effect,  in  their  personal  and 
professional  lives,  what  they  understood  these  two  specu- 
lative giants  to  be  advocating.  But  then  a  chance  remark 
provided  a  more  specific  cue;  and  when  I  returned  home 
I  hurried  to  consult  a  book  which  I  had  owned  for  some 
time  but  had  not  previously  read:  The  Meaning  of  Per- 
sons by  Paul  Tournier  (1957).  At  once  it  was  clear  that 
here  was  the  manual  which  was  inspiring  and  guiding  the 
strange  demonstration  I  had  witnessed — a  sort  of  Latter- 


178  The  Crisis  in  Psychiatry  and  Religion 

Day  Pentecost,  but  with  the  thunder  and  bolts  of  fire 
on  a  vastly  reduced  scale.  The  Fire,  in  fact,  was  mainly 
smoke  and  the  thunder,  just  "noise." 

At  this  meeting  a  sort  of  pass-phrase  which  I  heard 
repeatedly,  in  slightly  varied  versions,  was:  "But  I  want 
to  get  to  know  you,  the  real  you."  On  the  second  page 
of  his  first  chapter  (which  has  as  a  title  what  Harvey 
Cox  has  recently  characterized  as  "that  hardly  helpful 
question.  Who  Am  I?"),  Tournier  says: 

Day  after  day  men  and  women  of  all  ages  and  conditions, 
the  healthy  as  well  as  the  sick,  come  to  see  me  in  order  to 
learn  to  know  themselves  better.  They  tell  me  the  story  of 
their  lives.  They  take  great  trouble  to  get  the  details  abso- 
lutely right.  They  are  seeking  to  know  the  person  that  they 
themselves  really  are.  .  .  . 

What  matters  in  this  search  for  the  person  is  not  so  much 
historical  facts  as  the  way  in  which  we  see  and  feel  them. 
If  our  memories  deceive  us,  the  distortion  that  they  have 
undergone  is  by  no  means  accidental;  it  tells  us  as  much 
about  ourselves  as  do  the  facts  themselves  [italics  added]. 

And  a  few  pages  later  the  author  also  says: 

The  reader  will  see  now  why  it  is  that  this  problem  of  the 
person  has  for  twenty  years  been  of  such  absorbing  interest 
to  me.  It  has  a  general  significance  which  is  of  vital  im- 
portance for  all  thought  and  all  civilization:  what  is  man? 
But  it  also  has  a  particular  significance,  which  is  equally  im- 
portant for  my  life:  who  am  I,  really,  myself? 

It  is  a  question  which  haunts  each  one  of  us,  whether  we 
are  aware  of  it  or  not.  It  is  there  in  every  consultation  I  give. 
It  is  there  for  the  man  who  comes  to  see  me,  and  for  me  as 
well.  This  frank  and  living  contact  with  people  is  the  very 
substance  of  my  professional  life.  It  is  for  me,  quite  as  much  j 
as  for  the  man  who  consults  me,  a  means  of  discovering 
myself.  I  seek  to  attain  it  not  only  in  my  consulting-room,! 
but  all  the  time,  in  every  meeting  with  another  person,  in 
my  own  family,  with  my  friends,  in  conferences,  and  on  a 
holiday  (p.  14). 

And  my  friends  were  doing  it,  too,  at  the  conference 
— where,  objectively,  at  least,  they  were  supposed  to  be 
doing  something  else!  But  objectivity,  we  soon  discover, 
is  passe: 

When  we  evoke  our  memories,  we  can  never  be  quite  sur^ 
that   we   have   banished   all   illusion   from   them,   howevei 


Protestantism:  ii.  Challenge  and  Change        179 

sincere  we  are.  What  we  call  to  mind  is  not  the  facts  them- 
selves but  their  appearance,  the  way  in  which  we  saw  and 
felt  them.  All  that  we  have  seen  and  felt — images  and  sensa- 
tions— remains  more  or  less  distorted  in  our  memories  (p. 
12). 

There  was  a  tirrie  when  legend,  poetry  and  music  counted 
for  more  than  science  in  the  making  of  a  cultivated  man. 
,  .  .  One  of  Pirandello's  Six  Characters  in  Search  of  an  Au- 
thor declares  that  an  imaginary  being  like  Sancho  Panza  is 
more  real  than  any  real  man.  .  .  .  Where  then  is  the 
frontier  between  what  I  am  and  what  I  can  become?  (p.  13) . 

Even  Sancho  Panza  is  not  identical  for  everybody;  my  idea 
of  him  is  not  the  same  as  yours,  or  as  that  of  Cervantes. 
.  .  .  The  same  thing  happens  with  all  these  people  who 
come  to  see  me,  and  take  so  much  trouble  over  their  efforts 
to  describe  themselves  to  me  with  strict  accuracy  (p.  14). 

Twenty  years  earlier,  we  discover,  Buber  in  his  booklet 
What  Is  Man?  was  making  substantially  the  same  point: 

When  imagining  and  illusions  are  over,  the  possible  and 
inevitable  meeting  of  man  with  himself  is  able  to  take  place 
only  as  the  meeting  of  the  individual  with  his  fellow-man — 
and  this  is  how  it  must  take  place.  Only  when  the  individual 
knows  the  other  in  all  his  otherness  as  himself,  as  man,  and 
from  there  breaks  through  to  the  other,  has  he  broken 
through  his  solitude  in  a  strict  and  transforming  meeting. 

It  is  obvious  that  such  an  event  can  only  take  place  if  the 
person  is  stirred  up  as  a  person  (pp.  201-202). 

And  precisely  how  is  this  to  transpire?  The  answer: 

In  real  conversation,  ...  a  real  lesson  .  .  .  ,  a  real  em- 
brace and  not  one  of  mere  habit,  a  real  duel  and  not  a  mere 
game — in  all  these  what  is  essential  does  not  take  place  in 
each  of  the  participants  or  in  a  neutral  world  which  includes 
the  two  and  all  other  things;  but  it  takes  place  between  them 
in  the  most  precise  sense,  as  it  were  in  a  dimension  which  is 
accessible  only  to  them  both.  Something  happens  to  me — 
that  is  a  fact  which  can  be  exactly  distributed  between  the 
world  and  the  soul,  between  an  "outer"  event  and  an  "inner" 
impression.  But  if  I  and  another  come  up  against  one  an- 
other, "happen"  to  one  another,  .  .  .  the  sum  does  not 
exactly  divide,  there  is  a  remainder,  somewhere,  where  the 
souls  end  and  the  world  has  not  yet  begun,  and  this  re- 
mainder is  what  is  essential.  .  .  . 

On  the  far  side  of  the  subjective,  on  this  side  of  the  ob- 
jective, on  the  narrow  ridge,  where  I  and  Thou  meet,  there 
.   is  the  realm  of  "between"  (p.  204). 


180  The  Crisis  in  Psychiatry  and  Religion 

This  reality  provides  the  starting-point  for  the  philosophical 
science  of  man;  and  from  this  point  an  advance  may  be 
made  on  the  one  hand  to  a  transformed  understanding  of 
the  person  and  on  the  other  to  a  transformed  understanding 
of  community.  The  central  subject  of  this  science  is  neither 
the  individual  nor  the  collective  but  man  with  man  (p.  205). 

What,  then,  can  one  say  to  all  this?  There  is  something 
undeniably  appealing  and  wistful  about  it,  but  can  it  be 
put  to  work  in  the  everyday  world?  In  the  same  context 
from  which  the  foregoing  passages  come,  Buber  refers  to 
"something  ontic,"  and  there  is  now  in  Chicago  and  one 
or  two  other  cities  in  this  country  an  Onto-Analytic 
Society.  And  various  forms  of  Existential  Analysis  have 
been  practiced  in  Europe  for  some  years.  But  is  their 
record  any  better  than  that  of  psychoanalysis?  In  an 
oblique  criticism  of  the  latter,  Buber  writes: 

We  have  seen  that  an  individualistic  anthropolgy,  an  an- 
thropology which  is  substantially  concerned  only  with  the 
relation  of  the  human  person  to  himself,  with  the  relation 
within  this  person  between  the  spirit  and  its  instincts,  and 
so  on,  cannot  lead  to  a  knowledge  of  man's  being  (p.  199, 
italics  added). 

The  emphasis  on  the  relation  of  man-to-man  is,  surely, 
an  improvement  upon  Freudian  doctrine;  but  is  there  not 
still  a  serious  ambiguity  here?  The  emphasis,  as  Tour- 
nier's  phrasing  especially  suggests,  is  still  upon  one's 
coming  to  know  himself.  Don't  we,  in  fact,  know  our- 
selves only  too  well  and  sicken  of  this  knowledge,  yet  are 
loath  to  let  others  know,  in  the  same  sense,  who  we  are? 
I  do  not  mean  "others"  in  the  sense  of  a  professional 
listener  who  is  paid  to  keep  our  secrets,  but  in  Sullivan's 
sense  of  the  significant,  ordinary  others  in  our  lives :  rela- 
tives, friends,  colleagues,  neighbors.  Here  is  where  the 
real  "break-through"  to  community  and  personal  au- 
thenticity comes;  and  anything  which  falls  short  of  this 
is,  I  submit,  a  pious  hope. 

II.   PERSONS  OR  PRINCIPLES? 

For  the  atmosphere  created  at  the  conference  and  the 
prevailing  tone  of  the  quotations  from  Tournier  and 
Buber  in  the  preceding  section,  there  is  surely  only  one 


Protestantism:  n.  Challenge  and  Change        181 

apt  word:  mystical.  And  since  Orientals,  rather  than 
Westerners,  have  cultivated  the  occult  so  much  longer,  it 
is  no  accident  that  we  should  now  be  turning  to  them 
for  real  expertness  in  these  matters.  Zen  Buddhism  has 
already  achieved  at  least  a  minor  vogue  in  this  country; 
and  recently  a  full-page  ad  by  Harper  and  Brothers  in  the 
Christian  Century  was  headed:  "Books  on  Eastern  Reli- 
gions for  Western  Readers."  A  few  weeks  ago  a  former 
student,  as  a  pleasant  gesture,  sent  me  a  copy  of  The 
Wisdom  of  Laotse  (Lin  Yutang,  1948).  Laotse  was  a 
Taoist,  and  Taoism  is  one  of  the  direct  and  dominant 
tributaries  of  Zen.  Open  the  Laotse  book,  almost  at 
random,  and  here  is  the  sort  of  thing  one  finds: 

Life  arises  from  death,  and  vice  versa.  Possibility  arises 
from  impossibility,  and  vice  versa.  Affirmation  is  based  upon 
denial,  and  vice  versa.  Which  being  the  case,  the  true  Sage 
rejects  all  distinctions  and  takes  his  refuge  in  Heaven  (p.  49). 

And  to  this  intellectual  nihilism  is  added  moral  nega- 
tivism or  at  least  neutrality.  For  example,  we  read: 

The  man  of  character  lives  at  home  without  exercising  his 
mind  and  performs  actions  without  worry.  The  notions  of 
right  and  wrong  and  the  praise  and  blame  of  others  do  not 
disturb  him.  When  within  the  four  seas  all  people  can  enjoy 
themselves,  that  is  happiness  for  him;  when  all  people  are 
well  provided,  that  is  peace  for  him.  Sorrowful  in  coun- 
tenance, he  looks  like  a  baby  who  has  lost  his  mother;  ap- 
pearing stupid,  he  goes  about  like  one  who  has  lost  his  way. 
He  has  plenty  of  money  to  spend,  and  does  not  know  where 
it  comes  from.  He  drinks  and  eats  just  enough  and  does  not 
know  where  the  food  comes  from.  This  is  the  demeanor  of 
the  man  of  character  (p.  129). 

Now  it  is  a  good  thing,  surely,  to  have  international 
trade,  both  in  the  realm  of  material  things  and  in  ideas. 
But  when  we  start  importing  and  extensively  appropriat- 
ing notions  which  by  traditional  Western  standards  are 
patent  nonsense,  we  need  to  look  well  to  our  condition. 
If  the  line  of  thought  we  have  pursued  in  the  preceding 
lecture  and  thus  far  in  this  one  is  sound,  the  facts  run 
something  like  this:  The  Calvinist  doctrine  of  the  guilt  of 
man  and  the  grace  of  God  (or  what  Tillich  has  called 
the  Protestant  Principle)  has  been  a  heresy  which  has 
produced  despair,  anger,  and  madness.  Freud,  with  a 


182  The  Crisis  in  Psychiatry  and  Religion 

great  flourish  of  scientific  objectivity  and  logic,  pretended 
to  deliver  us  by  going  all  the  way  and  taking  from  us 
responsibility  both  for  our  sins  and  our  salvation.  The 
result:  moral  collapse  and  chaos!  Now,  feebly,  in  a  sort 
of  hebephrenic  languor,  we  are  toying  with  Asiatic  abstrac- 
tions that  make  about  as  much  sense  as  does  modern  ab- 
stractionist art.  Is  this  the  best  we  can  do?  Perhaps, 
but  I  believe  there  is  an  alternative  way  of  approaching 
the  problem  which  we  should  consider  very  seriously: 
namely,  to  assume  that  there  are  principles — universal, 
consistent,  knowable  principles — in  the  domain  of  hu- 
man personality  and  social  process  which  transcend  *'per- 
sons,"  and  that  we  can  know  others  and  be  ourselves,  in 
the  ultimate  sense,  only  in  terms  of  these  principles. 

Today  we  are  hearing  a  great  deal,  in  some  quarters, 
about  God  as  person.^  But  from  the  personal  emphasis, 
we  easily  move  to  the  subjective;  and,  as  we  have  just 
seen,  it  is  also  but  a  short  step  from  the  subjective  to 
mysticism  and  chaos.  For  myself — and  here  I  think  I 
speak  for  many  others — what  I  want  is  a  clearer  knowledge 

^For  example,  Hordern  (1955),  in  describing  the  theological 
position  of  William  Temple,  Archbishop  of  Canterbury,  writes: 
■"The  supreme  revelation  is  given  in  the  life  and  person  of 
Jesus.  The  revelation  is  not  his  teaching  or  his  acts  but  him- 
self. .  .  .  Christianity  is  not  a  dedication  to  a  system  of  rules 
or  of  thought,  but  a  dedication  to  a  person.  This  is  unique 
among  the  religions  of  the  world"  (p.  190).  This  emphasis 
upon  God-as-person  is  likely  to  strike  the  skeptic  as  a  patent 
absurdity;  and  it  is  also,  it  seems,  of  doubtful  practical  assist- 
ance to  the  nominal  believer  when  he  is  in  emotional  difficul- 
ties. One  can  rebuild  his  life,  in  a  constructive  and  satisfying 
manner,  along  lines  laid  down  by  Christ's  ethical  teachings;  but 
the  notion  of  the  "mystical"  union  with  Christ  has,  I  submit, 
little  value  save  as  a  topic  for  endless  theological  disquisition.  I 
once  took  a  young  Polish  psychologist  (who  was,  I  presume, 
also  something  of  a  Communist)  to  the  first  Christian  church 
service  he  had  ever  attended;  and  afterwards,  he  was  quiet  for 
a  few  minutes  and  then  thoughtfully  asked,  "And  what  are 
all  those  people  going  to  do  now?"  What  could  I  say?  The 
truth  is  there  isn't  much  that  a  person  can  do  about  much 
Protestant  preaching,  except  to  go  back  next  week  and  hear 
more  of  it.  The  de-emphasis  on  preaching  and  stress  upon 
action,  deeds,  works  in  the  Catholic  Church  surely  has  some- 
thing to  recommend  it.  (Cf.  a  similar  emphasis  in  the  Mormon 
and  Moslem  religions.)  ^ 

■M 


Protestantism:  ii.  Challenge  and  Change        183 

of  principles,  which  we  can  learn  to  obey  and  thereby 
live  abundantly  or,  if  we  choose,  disobey  and  suffer  the 
consequences.  A  friend  who  is  a  state  mental  hospital 
chaplain  tells  me  that  a  point  which  he  often  makes  with 
patients  is  this:  "We  don't  break  God's  laws.  They 
break  us,  if  we  disregard  or  defy  them."  Isn't  this 
what  we  need  to  know,  more  about  how  the  Universe  is 
constructed  and  operated,  in  the  psychological  and  moral 
realm,  so  that  we  can  conduct  our  lives  more  intelligently 
and  more  meaningfully?  If,  in  the  physical  realm,  we 
observe  the  Laws  of  Gravity,  we  get  along  nicely;  if,  on 
the  other  hand,  we  disregard  them,  we  may  have  a 
broken  neck  to  show  for  it.  But  do  we  "break"  the  prin- 
ciples of  gravity?  Not  in  the  least,  they  break  us. 

There  is  thus,  as  I  see  it,  no  place  for  Calvinistic  logic 
in  the  modern  world:  we  have,  it  seems,  a  completely 
symmetrical  choice  between  observing  natural  principles 
and  prospering,  on  the  one  hand,  and  disregarding  them 
and  getting  into  trouble,  on  the  other.  And  we  have 
just  as  much  responsibility — and  deserve  just  as  much 
"credit,"  positive  or  negative — in  the  one  case  as  in  the 
other.  If  we  are  to  end  the  wasteful  and  undignified 
conflict  between  scientific  and  religious  world  views,  it 
must  surely  be  along  these  lines;  and  it  is,  I  submit, 
along  the  very  same  lines  that  the  ecumenical  movement 
within  religion  itself  also  has  the  best  prospects  of  suc- 
cess. As  long  as  different  religious  groups  focus  upon 
personages,  which  are  of  necessity  unique,  they  will 
remain  apart;  but  when  they  begin  to  look  at  the  prin- 
ciples which  they  have  in  common,  reconciliation  and 
union  are  by  no  means  improbable. 

Especially  interesting  in  this  connection  is  another 
passage  from  the  article  by  Richard  Niebuhr  which  I 
have  already  [Chapter  11]  cited.  It  reads  as  follows: 

Experience  and  study  [over  the  past  25  years]  both  have 
led  to  some  changes  in  the  theological  formulation  of  [my] 
convictions.  The  complex,  dynamic,  interhuman  as  well  as 
the  human-divine  interaction  of  trust  and  loyalty  has  excited 
my  wonder  and  challenged  my  efforts  to  understand  faith 
more  than  ever.  Perhaps  it  is  this  concentration  on  faith 
as  trust  and  loyalty  which  had  led  me  farther  away  from  the 
road  that  many  other  postliberals — particularly  Karl  Barth — 
have  taken.  So  many  of  them  seem  to  me  to  have  gone  back 


184  The  Crisis  in  Psychiatry  and  Religion 

to  orthodoxy  as  right  teaching,  right  doctrine,  and  to  faith 
as  fides,  as  assent;  they  tend,  it  seems  to  me,  toward  the 
definition  of  Christian  hfe  in  terms  of  right  beheving,  of 
Christianity  as  the  true  rehgion,  and  otherwise  toward  the 
assertion  of  the  primacy  of  ideas  over  personal  relations. 
When  I  think  about  this  I  have  to  say  to  myself  that  impor- 
tant as  theological  formulations  are  for  me  they  are  not  the 
primary  one.  I  discover  further  a  greater  kinship  with  all 
theologians  of  Christian  experience  than  with  the  theolo- 
gians of  Christian  doctrine.  So  I  find  myself,  though  with 
many  hesitations,  closer  to  Edwards  and  Schleiermacher,  to 
Coleridge,  Bushnell  and  Maurice  than  to  Barth  and  the 
dogmatic  biblical  theology  current  today  in  wide  circles.  To 
state  my  understanding  of  our  theological  situation  briefly:  I 
believe  that  the  Barthian  correction  of  the  line  of  march 
begun  in  Schleiermacher's  day  was  absolutely  essential,  but 
that  it  has  become  an  over-correction  and  that  Protestant 
theology  can  minister  to  the  church's  life  more  effectively  if 
it  resumes  the  general  line  of  march  represented  by  the  evan- 
gelical, empirical  and  critical  movement.  Some  new  studies 
in  modern  theology  have  convinced  me  that  the  movement 
from  Schleiermacher  to  Troeltsch  was  by  no  means  so  hu- 
manistic as  its  critics  have  asserted.  Existentialism  also  has 
served  to  reinforce  my  concern  for  the  personal,  for  the  reli- 
giously experienced,  for  I-Thou  relations  between  God  and 
man  and  between  men.  Among  contemporary  theologians  it 
is  Bultmann  who  above  all  seems  to  me  to  represent  this  em- 
pirical and  ethical  strain  in  theology  (pp.  249-250,  italics 
added). 


I 


Here,  as  I  see  it,  is  an  attempt  to  dissociate  religio 
from  theological  arrogance  and  abstraction  and  to  relate 
it  to  on-going  human  and  social  experience  and  need, 
in  a  way  which  is  immediately  attractive  to  the  person 
with  naturalistic,  scientific,  and  humanistic  predilections. 
Here  there  is  hope  of  finding  principles  of  living  on 
which  parish  ministers  and  social  scientists  can  deeply 
agree.  Here  is  an  attempt,  as  Niebuhr  explicitly  states,  to 
make  religion  empirical,  to  validate  it  by  its  accomplish- 
ments, instead  of  reducing  it  to  a  set  of  dogmatic  as- 
severations which  are  to  be  taken  purely  on  faith,  without 
any  reference  to  the  consequences  which  flow  from  them 
in  the  real  world. 

Niebuhr's  emphasis  upon  the  personal  and  interper- 
sonal is,  therefore,  a  very  welcome  one — and  sound,  pro- 
vided it  is  interpreted  and  implemented  in  terms  of 


Protestantism:  ii.  Challenge  and  Change        185 

definite  principles,  rather  than  as  a  "Cloud  of  Unknow- 
ing" (to  borrow  the  title  of  the  anonymous  book  on 
medieval  Christian  mysticism  which  Progoff,  1957,  has 
rendered  into  modern  English ) .  The  need  for  a  synthesis 
of  science  and  religion  in  the  psychological  and  social 
area  is  today  very  great,  and  here,  in  the  realm  of  the 
personal  and  the  interpersonal,  is  manifestly  the  place  to 
begin.  But  this  enterprise  will  not  prosper  if  we  rest  con- 
tent with  the  amorphous  utterances  of  Buber,  Tournier, 
and  other  Existentialists  or  if  we  drift  off  into  the  frank 
anti-intellectualism  and  ethical  nihilism  of  certain  Asiatic 
philosophies.  This  is  a  capital  challenge  to  both  con- 
temporary social  scientists  (see  Mowrer,  1961)  and  to 
clear-minded  and  courageous  religious  leaders,  such  as 
Niebuhr. 


III.    SOME   NONSENSE   ABOUT   SIN   AND   SINS 

It  is,  of  course,  painfully  clear  that  the  obstacles  to  a 
return  to  principle  in  the  moral  and  spiritual  realm  are 
formidable.  From  Luther  down  to  this  very  day,  there  is 
a  subtle  but  powerful  Protestant  doctrine  which  is  the 
very  antithesis  of  consistent,  objective  principle  in  this 
area.  Recently  I  heard  a  bright  well-educated  young 
minister  preach  a  sermon  from  which  I  wish  to  quote  at 
some  length: 

In  the  first  place,  we  need  to  understand  what  it  means  to 
say  that  we  are  sinners.  Usually  we  mean  by  "sinner"  some- 
body who  has  broken  a  rule  or  violated  a  law,  someone  who 
doesn't  conform  to  accepted  moral  and  social  standards.  .  .  . 

But  that  isn't  what  sin  means  in  the  Bible!  Sin  is  not  the 
accidental  breaking  of  a  rule,  but  the  willful  violation  of  a 
personal  relationship.  We  don't  sin  against  rules,  we  sin 
against  persons.  The  Biblical  God  relates  to  his  people  not 
primarily  as  a  Judge  to  an  offender,  but  as  a  Father  to  a  son 
who  has  rejected  his  love  and  wandered  away  into  a  far 
country.  Sin  is  what  we  were  talking  about  last  week.  It  is 
the  condition  into  which  men  meet  each  other  from  behind 
masks,  afraid  to  be  known  for  what  they  are.  Sin  is  when  we 
build  walls  of  isolation  and  security  to  avoid  the  demand  of 
men  to  be  loved  as  ourselves.  Sin  is  the  "thingification"  of 
persons — the  using  of  human  beings  for  what  good  they  can 
do  us,  rather  than  the  seeking  of  genuine  human  community. 
Sin  is  the  ritual  that  allows  us  to  glad-hand  and  smile  and 


186  The  Crisis  in  Psychiatry  and  Religion 

date  without  ever  knowing  the  person  we  so  casually  "con- 
tact." Have  you  ever  been  talking  with  someone  and  then 
realized  that  you  hadn't  really  heard  a  word  he  or  she  was 
saying?  Have  you  perhaps  lived  with  a  person  and  gone 
through  the  motions  of  friendship  or  marriage  and  suddenly 
realized  you  didn't  really  know  him? 

And  now  it  isn't  so  easy  to  slough  off  our  responsibility, 
is  it?  We  may  never  violate  the  commandments,  but  we 
may  know  very  well  what  it  means  to  treat  persons  as  things. 
Listen  to  our  poets,  our  dramatists,  our  sociologists,  our 
philosophers,  our  beatniks.  They  all  speak  with  one  voice, 
and  ask:  ''How  can  we  stop  brushing  by  each  other  the  way 
we  brush  by  a  blackboard  or  a  bush?  How  can  we  start 
being  human  to  each  other?"  That  question  shows  that,  by 
whatever  name  it  is  called,  sin  is  a  reality  to  modern  man. 

Here  we  have  it!  Sin  is  not  the  grubby,  mean,  vicious, 
duplicitous,  self-defeating  and  socially  destructive  things 
we  do.  It  can't  be  that  simple — otherwise,  we  would  not 
perhaps  need  so  much  preaching,  so  much  explaining  to 
understand  it.  No,  it  is  something  much  more  compli- 
cated, which  only  the  professional  theologian  can  fully 
fathom.  And  this  is  what  he  preaches  and  teaches  to  the 
laity,  despite  the  fact  that,  as  we  have  seen,  when  he 
personally  gets  into  emotional  hot  water,  he  finds  it 
precious  little  help,  judging  by  the  alactrity  with  which 
he  is  likely  to  resort  to  a  secular  therapist  of  some  sort 
[see  Chapter  11]. 

This  distinction  between  sins  and  Sin  was,  of  course, 
stressed  by  Luther,  during  the  Reformation,  in  his  attack 
upon  the  opposite  emphasis  of  the  Catholic  Church. 
But  it  has  extensive  roots  back  in  the  New  Testament 
itself  in  the  writings  of  the  Apostle  Paul;  and  it  is  no  ac- 
cident that  the  sermon  from  which  the  foregoing  quota- 
tion is  taken  was  buttressed  by  texts  from  the  Letter  to 
the  Ephesians,  wherein  the  familiar  Pauline  doctrine  of 
justification  by  faith  is  expounded  as  follows: 

But  God,  who  is  rich  in  mercy,  out  of  the  great  love  with 
which  he  loved  us,  even  when  we  were  dead  through  our 
trespasses,  made  us  alive  together  with  Christ  (by  grace  you 
have  been  saved),  and  raised  us  up  with  him,  and  made  us 
sit  with  him  in  the  heavenly  places  in  Christ  Jesus,  that  in 
the  coming  ages  he  might  show  the  immeasurable  riches  of 
his  grace  in  kindness  toward  us  in  Christ  Jesus.  For  by  grace 
you  have  been  saved  through  faith,  it  is  the  gift  of  God — not 


Protestantism:  ii.  Challenge  and  Change        187 

because  of  works,  lest  any  man  should  boast.  For  we  are  his 
workmanship,  created  in  Christ  Jesus  for  good  works,  which 
God  prepared  beforehand,  that  we  should  walk  in  them 
(2:4-10). 

But  now  in  Christ  Jesus  you  who  once  were  far  off  have 
been  brought  near  in  the  blood  of  Christ.  For  he  is  our 
peace,  who  has  made  us  both  one,  and  has  broken  down 
the  dividing  wall  of  hostility,  by  abolishing  in  his  flesh  the 
law  of  commandments  and  ordinances,  that  he  might  create 
in  himself  one  new  man  in  place  of  the  two,  so  making 
peace,  and  might  reconcile  us  both  to  God  in  one  body 
through  the  cross,  thereby  bringing  the  hostility  to  an  end 
(2:14-16). 

Here,  clearly,  is  Biblical  authority  for  Luther's  enig- 
matic injunction  to  "Love  God  and  sin  boldly"  (since 
our  sins  are  already  forgiven  before  we  commit  them) 
and,  equally,  for  Calvin's  doctrine  of  predestination 
("which  God  prepared  beforehand").  Paul  (Ephesians 
3:4)  concedes  that  all  this  is  "the  mystery  of  Christ" 
but  claims  he  has  "insight"  into  it.  Can  it  be  that  the 
mystery  is  largely  of  his  own  making  and  that  although 
he  perhaps  understood  it,  few  have  since  been  similarly 
blessed. 

It  is  not  surprising,  perhaps,  that  Lloyd  C.  Douglas, 
while  he  was  still  a  Congregationist  minister,  and  before 
he  became  a  great  novelist,  often  referred  to  Paul  as 
"that  noisy  troubadour  from  Tarsus!"  Even  though  his 
mellifluous  phrases  have  rumbled  on  down  through  the 
centuries,  it  is  still  not  certain  whether  they  make  any 
real  sense.  In  Paul's  own  time,  he  had  a  trenchant  critic 
in  the  writer  of  the  Epistle  of  James,  who  needs  only 
three  and  a  half  pages  to  refute  the  essence  of  what 
Paul  takes  88  pages,  or  nearly  a  third  of  the  New  Testa- 
ment (RSV),  to  say. 

What  does  it  profit,  my  brethren,  if  a  man  says  he  has 
faith  but  has  not  works?  Can  faith  save  him?  If  a  brother  or 
sister  is  ill  clad  and  in  lack  of  daily  food,  and  one  of  you  say 
to  them,  "Go  in  peace,  be  warm,"  what  does  it  profit?  So 
faith  by  itself,  if  it  has  no  works,  is  dead  (2:14-17). 

Show  me  your  faith  apart  from  your  works,  and  I  by  my 
works  will  show  you  my  faith  (2:18). 

You  see  that  a  man  is  justified  by  works  and  not  by  faith 
alone.  And  in  the  same  way  was  not  also  Rahab  the  harlot 
justified  by  works  when  she  received  the  messengers  and  sent 


188  The  Crisis  in  Psychiatry  and  Religion 

them  out  another  way?  For  as  the  body  apart  from  the 
spirit  is  dead,  so  faith  apart  from  works  is  dead  (2:24-26). 

Fundamentalists,  literalists,  and  revelationists  some- 
times make  a  great  point  of  the  internal  consistency  of 
the  Bible.  One  need  not  be  a  Biblical  expert  to  know 
that  James  was  in  direct  and  emphatic  disagreement  with 
Paul.  And  K.  W.  Lowther  Clark,  in  his  authorative  Con- 
cise Bible  Commentary,  adds:  "The  impulse  [which 
prompted  the  Epistle  of  James]  was  supplied  by  the 
desire  to  recall  Christians  to  reality  in  religion;  [the 
author]  had  seen  the  unfortunate  impression  made  on 
some  minds  by  reports  of  St.  Paul's  teaching  and  wished 
to  counteract  if  (p.  915,  italics  added ).2 

^  Since  the  above  was  written  I  have  received  a  letter  from 
a  clergyman  of  Calvinist  persuasion  which  reads  in  part  as 
follows:  "Ever  since  your  opening  address  [see  Chapter  8],  I 
have  also  wondered  about  something  else  which  maybe  you 
could  answer  for  me.  If  I  remember  correctly,  it  was  your 
belief  that  many  times  we  make  forgiveness  too  easy.  Man  has 
worked  his  way  into  sin;  he  must  somehow  be  given  the  op- 
portunity to  work  his  way  out.  Your  reference  to  the  old- 
fashioned  mourners'  bench  especially  intrigued  me.  Could  it  be, 
however,  that  this  is  due  to  the  fact  that  we  have  separated  the 
doctrine  of  the  substitutionary  atonement  from  the  offer  of 
forgiveness?  I  mean  that  if  we  preached,  what  I  believe  to  be 
the  teaching  of  the  Bible,  that  Christ  was  bearing  the  wrath  of 
God  against  sin,  that  he  was  being  punished  for  my  sin,  that 
we  would  not  think  of  it  as  cheap  and  easy?  I  can  never  atone 
for  my  sin,  but  Christ  has  done  that  for  me.  He  has  paid  the 
price.  He  bore  the  punishment  due  me;  and  my  union  with 
him  through  faith  means  that  my  sins  have  been  punished  and 
I  can  now  have  a  clear,  clean  conscience."  Here  is  an  epitome 
of  the  Great  Idea  which  Reformation  theologians  spread 
abroad  in  the  world!  If  one  is  pleased  with  the  present  status 
and  prospects  of  Protestantism,  after  four  hundred  years,  one 
should  by  all  means  persevere  in  this  ambiguous  and  bloody 
doctrine.  But  for  a  growing  minority  (or  is  it  now,  in  fact, 
majority?),  it  just  won't  do.  The  discrepancy  between  the  be- 
liefs professed  by  many  modern  ministers  from  their  pulpits 
and  their  personal  practices  when  in  emotional  difficulties  has 
been  commented  on  in  some  detail  in  the  first  lecture  of  this 
series.  And  a  little  later  in  the  present  discussion,  we  shall 
allude,  at  least  sketchily,  to  the  much  over-worked  concept  of 
forgiveness.  However,  no  attempt  is  made  here  [or  elsewhere  in 
this  volume]  to  deal  in  any  systematic  way  with  the  whole 


Protestantism:  ii.  Challenge  and  Change        189 

Although  the  CathoHc  Church  has  made  a  mystery 
and  a  muddle  of  many  things,  in  this  issue  between 
Paul  and  James  it  has  been  clear-headed — and  thoroughly 
Jamesian.  It  has  stressed  the  importance  of  good  works 
(as  a  means  of  correcting  sins,  without  much  reference 
to  Sin)y  with  implicit  recognition  of  a  "balance  sheet"  on 
which  our  sins  and  virtues  add  algebraically.  As  Tillich 
(1959)  observes  in  the  sermon  previously  cited: 

Our  moral  balance  sheet  is  not  so  bad  as  it  would  be  with- 
out these  acts!  And  did  you  ever  see  a  preacher  of  what  is 
called  the  "total  depravity"  of  man  who  did  not  show  in  his 
own  behavior  a  reliance  on  a  positive  moral  balance  sheet? 
(p.  17). 

But  the  emphasis  in  the  writings  of  Paul,  and  in  Prot- 
estant theology  generally,  has  been  on  a  very  different 
note,  namely,  that  in  the  Substitutionary  Atonement 
(Christ's  crucifixion),  Cod  wiped  the  ''balance  sheet" 
clean  for  all  time  and  for  all  men,  provided  only  that 
they  say,  "I  believe.  .  .  ."  In  "accepting  Christ  as  our 
personal  redeemer,"  sin  is  supposedly  banished  in  our 
lives  and  we  are,  from  this  point  on,  "saved."  This  is 
what  Deitrich  Bonhoeffer,  in  his  book  The  Cost  of 
Discipleship,  dubs  the  doctrine  of  cheap  grace,  a  doctrine 
which  has  been  a  disgrace  and  a  scandal  to  Christendom. 
It  is  a  doctrine  which  holds  the  deep  natural  wisdom  of 
the  Judeo-Christian  ethic  in  contempt — and  prevents  us 
from  coming  to  grips  effectively  with  the  most  profound 
personal  problem  of  our  time,  mental  illness. 

IV.   RETURN  TO  CONFESSION,   WITH  A  DIFFERENCE 

The  crux  of  our  present  predicament,  then,  is  that 
Protestantism  has  embraced  a  theology  which  put  the 

notion  of  sacrifice,  as  a  therapeutic  force.  Although  Christ  un- 
doubtedly made  a  great  personal  sacrifice  (of  allowing  himself 
to  be  crucified  for  his  conviction,  rather  than  quietly  slipping 
off  into  the  desert,  as  he  easily  could  have),  I  believe  a  wholly 
unjustified  cult  has  grown  up  around  this  act  which  completely 
distorts  the  historical  facts  and  blinds  our  present-day  percep- 
tion in  some  vitally  important  areas.  However,  this  topic  is  so 
complex,  and  vital,  that  I  am  reserving  it  for  special  treatment 
in  a  lecture  to  be  given  shortly  at  the  Allan  Memorial  Institute 
of  Psychiatry,  at  McGill  University,  in  Montreal.  It  will  be 
published  separately,  at  a  later  date. 


190  The  Crisis  in  Psychiatry  and  Religion 

problem  of  personal  guilt  beyond  the  scope  of  religion 
and  thus  fostered  the  development  of  secular  psycho- 
therapy in  general  and  Freudian  psychoanalysis  in  partic- 
ular. But  analytic  treatment  and  theory,  far  from  lessen- 
ing our  woes,  have  exacerbated  them;  and  we  are  today 
looking  to  religion,  once  again,  with  renewed  hope  and 
urgency.  We  have  tried  to  believe  that  personality  dis- 
order is  basically  an  illness — mental  illness;  but  we  are 
now  increasingly  persuaded  that  the  problem  is  funda- 
mentally moral,  that  the  guilt  which  is  so  obviously 
central  in  psychopathology  is  real  rather  than  false,  and 
that  only  a  moral  attack  upon  this  problem  can  be  suc- 
cessful. We  had  hoped  that  an  easy  solution  might  be 
found  for  personal  evil;  and  we  have  tried  both  the  doc- 
trine of  ''cheap  grace"  (in  religion)  and  the  strategy  of 
denying  the  reality  of  sin  and  guilt  altogether  (in  psy- 
choanalysis), but  neither  has  worked.  And  so  today 
there  is  a  growing  readiness  to  accept  the  verdict  that 
''therapy,"  or  "salvation,"  is  possible  only  at  great  cost: 
the  cost  of  self-revelation,  deep  contrition,  and  a  radi- 
cally changed  way  of  life. 

The  injunction  to  engage  in  auricular  confession  is 
still  to  be  found  in  the  Protestant  Episcopal  Book  of 
Common  Prayer;  and  a  similar  admonition  is  also  present 
in  most  forms  of  Lutheranism.  However,  the  actual  prac- 
tice of  confession  has  largely  fallen  into  disuse  in  these 
denominations;  and  among  more  radically  Protestant 
groups,  confession  has  long  been  regarded  as  papish  and 
hence  to  be  shunned  like  the  plague.  In  the  pastoral 
counseling  movement,  there  has,  of  course,  been  a  sort  of 
half-hearted,  disguised  return  of  confession.  But  this 
movement  has  been  so  dominated  by  ideas  and  tech- 
niques which  have  been  appropriated  from  secular  forms 
of  psychotherapy  that  the  results  have  been  quite  am- 
biguous. Protestant  churches  must,  I  believe,  rethink  and 
revitalize  their  efforts  in  this  direction. 

Luther,  we  should  recall,  was  not  protesting  against  the 
institution  of  confession  as  such,  but  against  its  abuse. 
Over  the  years,  however,  the  assumption  seems  to  have 
developed  that  the  only  way  to  prevent  this  abuse  is  to 
eliminate  the  institution  itself.  This  is  like  arguing  that 
because  surgery,  in  incompetent  or  unscrupulous  hands, 
can  be  misused,  it  should  be  eliminated  altogether.  Mani- 


Protestantism:  ii.  Challenge  and  Change        191 

festly  some  means  must  be  found  whereby  ordinary 
mortals  can  work  through  the  problem  of  personal  guilt 
n  a  way  which  is  more  effective  than  anything  which  is 
it  present  generally  available.  And  the  indications  are 
:hat  confession,  in  a  moral  and  religious  context,  is  the 
ogical  starting  point.  In  his  book.  Life  Together,  Deitrich 
Bonhoeffer  devotes  the  last  chapter  to  the  topic  of  "Con- 
iession  and  Communion."  Here  he  says: 

"Confess  your  faults  one  to  another"  (Jas.  5:16).  He  who 
is  alone  with  his  sin  is  utterly  alone.  It  may  be  that  Chris- 
tians, notwithstanding  corporate  worship,  common  prayer^ 
and  all  their  fellowship  in  service,  may  still  be  left  to  their 
loneliness.  The  final  break-through  to  fellowship  does  not 
occur,  because,  though  they  have  fellowship  with  one  an- 
other as  believers  and  as  devout  people,  they  do  not  have  fel- 
lowship as  the  undevout,  as  sinners.  The  pious  fellowship 
permits  no  one  to  be  a  sinner.  So  everybody  must  conceal  his 
sin  from  himself  and  from  the  fellowship.  We  dare  not  be 
sinners.  Many  Christians  are  unthinkably  horrified  when  a 
real  sinner  is  suddenly  discovered  among  the  righteous.  So  we 
remain  alone  with  our  sin,  living  in  lies  and  hypocrisy.  The 
fact  is  that  we  are  sinners!  (p.  110). 

In  confession  the  break-through  to  community  takes  place. 
Sin  demands  to  have  a  man  by  himself.  It  withdraws  him 
from  the  community.  The  more  isolated  a  person  is,  the 
more  destructive  will  be  the  power  of  sin  over  him,  and  the 
more  deeply  he  becomes  involved  in  it,  the  more  disastrous  is 
his  isolation.  Sin  wants  to  remain  unknown.  It  shuns  the 
light.  In  the  darkness  of  the  unexpressed  it  poisons  the 
whole  being  of  a  person.  This  can  happen  even  in  the  midst 
of  a  pious  community.  In  confession  the  light  of  the  Gospel 
breaks  into  the  darkness  and  seclusion  of  the  heart.  The  sin 
.  must  be  brought  into  the  light.  The  unexpressed  must  be 
openly  spoken  and  acknowledged.  All  that  is  secret  and 
hidden  is  made  manifest.  It  is  a  hard  struggle  until  the  sin 
is  openly  admitted.  But  God  breaks  gates  of  brass  and  bars 
of  iron  (Ps.  107:16)    (p.  112). 

In  his  book  The  Riddle  of  Roman  Catholicism,  Jaro- 
;lov  Pelikan  writes: 

Through  the  administration  of  these  three  steps — contri- 
tion, confession,  and  satisfaction — the  church  has  a  splendid 
opportunity  to  apply  the  healing  power  of  the  gospel  to  the 
concrete  needs  of  the  penitent.  In  the  hands  of  a  conscien- 
tious pastor,  the  sacrament  of  penance  makes  divine  grace 


192  The  Crisis  in  Psychiatry  and  Religion 

meaningful  without  minimizing  the  individual's  responsibil- 
ity for  his  sin.  It  is,  at  its  best,  a  truly  evangelical  means  for 
"the  cure  of  souls,"  one  whose  benefits  Protestantism  has 
discarded  too  easily,  and  one  for  which  a  friendly  chat  with 
the  minister  is  not  a  satisfactory  substitute.  Psychologically, 
too,  private  confession  is  sound,  enabling  a  person  to  "come 
clean"  about  his  feelings  and  to  know  that  he  has  forgive- 
ness from  God  in  spite  of  anything  he  may  have  done.  The 
therapeutic  value  of  this  is  difficult  to  overestimate  (pp. 
120-121). 

And  Meehl  et  at  (1958),  in  their  book  What,  Then, 
Is  Man?y  take  a  similar  position.  They  say: 

One  of  the  facets  of  confession  which  is  often  viewed 
superficially  in  pastoral  practice,  or  even  ignored,  is  the  de- 
tailed or  specific  confession  of  actual  sins.  Many  of  the 
Lutheran  clergy  do  not  minister  to  the  needs  of  their  parish- 
ioners adequately  because  they  are  content  when  their  peo- 
ple participate  in  general  confessions  instead  of  insisting 
upon  the  health-giving  function  of  specific  confessions,  as 
the  Lutheran  Catechism  and  standard  works  in  Lutheran 
pastoral  theology  recommend.  The  result  has  been  that  the 
act  of  confession  has  become  secularized.  Educated  people 
especially  seem  more  often  to  feel  that  their  needs  are  better 
met  by  psychoanalysis  than  the  Word  of  God.  Our  pastors 
ought  to  re-examine  both  the  healing  power  of  the  Gospel 
and  the  apparent  self-sufficiency  of  their  parishioners. 

If  the  non-Christian  psychotherapeutic  effort  has  become 
vastly  greater  in  our  society  and  has  obtained  enormous  recog- 
nition among  our  own  people,  it  is  in  part  the  consequence 
of  superficial  pastoral  care.  Though  it  must  not  become  ex- 
aggerated, so  that  it  confers  upon  the  pastor  the  role  of 
grand  inquisitor,  there  is  nonetheless  such  a  thing  as  peniten- 
tial discipline  to  which  all  Christians  ought  regularly  to  sub* 
mit.  Self-knowledge  really  exists  only  to  the  extent  that  one 
does,  or  is  able  to,  communicate  it  in  speech  to  another 
person.  The  psychotherapeutic  value  of  making  specific,  or 
even  detailed,  confessions  is  therefore  very  great  (pp.  68-69). 

As  it  happens  the  three  writers  just  cited  are  all  Lu- 
therans. But  men  in  other  Protestant  denominations  have 
made  similar  statements,  some  of  them  very  much  earlier 
than  the  ones  we  have  just  reviewed.  For  example,  Hol- 
man  (1943),  in  a  review  of  H.  E.  Fosdick's  book.  On 
Being  a  Real  Person,  wrote: 


ROTESTANTISM:    II.   CHALLENGE  AND  ChANGE  193 

Away  back  in  1927  Dr.  Fosdick,  then  pastor  of  the  Park 
Avenue  Baptist  Church,  New  York  City,  gave  an  address 
before  the  Greater  New  York  Federation  of  Churches  which 
immediately  brought  expressions  of  angry  resentment  or  warm 
approval  from  Protestant  ministers  in  all  parts  of  the  country. 
Said  Dr.  Fosdick: 

"We  modern  Protestants  fail  in  some  things.  Our    . 
Roman  Catholic  brethren  in  keeping  the  confessional 
have  pretty  nearly  wiped  us  off  the  stage  in  one  feature 
of  human  service.  .  .  . 

*Tor  six  years  I  have  conducted — Baptist  though  I  am 
— what  I  call  a  confessional.  ...  I  have  an  office 
where  people  who  know  they  are  spiritually  sick  and 
mentally  disturbed  can  come  with  their  problems.  Why 
shouldn't  I  minister  to  them?  Never  again  will  I  be 
without  such  a  place  where  people  can  meet  me  alone. 
Week  after  week  I  meet  nearly  as  many  people  as  a 
priest.  They  are  mentally  unbalanced — sick  souls  who 
need  ministration"  (p.  214). 

What,  then,  has  thus  far  been  the  fruit  of  this  grow- 
[g  awareness  of  the  need  for  a  return  to  confession  in 
le  Protestant  churches?  Fosdick's  early  interests  were,  as 
e  know  [Chapter  6],  very  largely  absorbed  and  diverted 
f  the  pastoral  counseling  movement,  which  has  been 
3minated  by  ideas  taken  from  Freudian  psychoanalysis 
id  the  counseling  methods  of  Carl  Rogers.  This  move- 
lent  leaves  much  to  be  desired;  and  it  is  not  without 
gnificance  that  there  is  a  new  concern,  on  the  part  of 
ich  men  as  Bonhoeffer,  Pelikan,  and  Meehl,  with  the 
lerapeutic  and  redemptive  potentialities  of  confession. 
t  the  same  time,  however,  there  are  some  deep-seated 
id  at  least  partially  justified  reservations.  We  have  con- 
antly  before  us  the  fact  that  confession  has  long  been, 
id  is  still,  practiced  in  the  Catholic  Church,  with  results 
hich  are  not  entirely  reassuring.  In  later  sections  we 
lall  go  into  this  problem  in  more  detail;  but  here  the 
)llowing  considerations  are  in  order. 

Whenever  confession  as  a  means  of  personal  redemp- 
on  and  change  is  under  discussion,  the  question  is  sure 
)  be  asked,  and  not  unreasonably:  Do  Catholics  enjoy 
ly  better  mental  health  than  do  members  of  other  reli- 
ions  or,  for  that  matter,  nonreligious  persons?  Mental 
ospital  statistics  are  likely  to  be  quite  ambiguous  on  this 


194  The  Crisis  in  Psychiatry  and  RELIGIO^ 

score.  The  religion  of  an  entering  patient,  if  any,  wil 
ordinarily  be  recorded  without  much  reference  tc 
whether  the  individual  has  recently  been  religiously  active 
or  inactive,  thus  obscuring  the  effects  of  the  conscientiou: 
observance,  or  disregard,  of  the  tenets  of  his  faith.  Bui 
there  are  independent  indications — such  as  lower  suicide 
rates,  lower  divorce  rates,  and  greater  resistance  to  **battl( 
fatigue" — that  Catholics  do  have  some  advantage  in  thi: 
connection.  However,  the  difference  is  not  dramatic.' 
Catholics,  laymen  and  members  of  the  monastic  anc 
priestly  orders  alike,  suffer  from  personality  disturbance 
both  mild  and  severe,  thus  indicating  that  confessior 
either  does  not  have  the  redemptive  and  therapeutic 
powers  sometimes  attributed  to  it  or  that — and  here  i: 
the  point  of  special  interest — there  are  serious  weaknesse 
in  the  way  confession  is  practiced  by  Catholics.  I  wish  t( 
discuss  these  weaknesses  in  the  following  order. 

1.  Catholic  confession  is  often  little  more  than  at 
empty,  perfunctory  formality.  I  have  a  friend  who,  whei 
the  occasion  offers,  makes  a  practice  of  sitting  in  Catholi( 
Churches  throughout  the  country  and  noting  the  tim< 
which  penitents  spend  in  the  confessional  booth.  Oi 
the  average  it  turns  out  to  be  about  60  seconds.  And  \ 
Catholic  chaplain  in  a  V.  A.  hospital  recently  volunteere( 
the  information  that  the  confessions  he  hears  from  tb 
patients  who  are  entrusted  to  his  care  usually  run  from  4( 
seconds  to  three  minutes.  Unless  extensively  supple, 
mented  by  interviews  outside  the  confessional,  this  typ. 
of  procedure  can  hardly  be  adequate  to  the  needs  of  evei 
ordinary  persons,  to  say  nothing  of  those  who  are  in  peij 
sonality  crisis.  \ 

Priests  vary  enormously  in  the  extent  to  which  they  arj 
interested  in  the  confessional.  Many  are  frank  to  say  thaj 
they  get  through  with  this  duty  just  as  speedily  as  pos] 
sible,  in  order  to  have  more  time  for  other  concerns.  Oi 
the  other  hand,  there  are  priests  who  give  major  attentioi 
to  this  aspect  of  their  work  and  who  become  widel; 
known  and  sought  after  as  confessors.  These  are  th 
men  who  are  likely  to  become  known  as  "spiritual  direc 
tors."  But  there  is  apparently  no  great  pressure  upoi 

®  There  is,  moreover,  some  indication  that  in  Catholi 
countries  the  incidence  of  suicide  is  not  accurately  reported 
because  of  the  great  opprobrium  associated  with  this  act. 


iotestantism:  ii.  Challenge  and  Change        195 

iests  to  emphasize  the  confessional,  except  in  its  sacra- 
ental  aspects;  and  there  is  also,  it  seems,  no  scarcity  of 
ithoHc  laymen  who  are  as  willing  to  handle  their  confes- 
ms  every  bit  as  routinely  as  are  many  priests. 

2.  The  penance  assigned  is  often  not  psychologically 
equate.  Although  I  have  not  yet  located  documentary 
oof  for  it,  Catholic  priests  tell  me  that  there  was  a 
ne  in  the  history  of  the  Church  when  penances  were 
iich  more  severe  than  they  are  today  and  were  more 
arly  designed  to  ''fit  the  crime."  Now  penance  often 
v^olves  nothing  more  than  saying  some  extra  prayers  and 
rhaps  burning  a  few  candles.  We  know,  of  course,  that 
dividual  human  beings,  when  overwhelmed  by  remorse 
d  guilty  fear,  are  inclined  to  be  quite  hard  on  them- 
ives;  and  it  is  not  surprising,  therefore,  that  the  pen- 
ces  assigned  by  the  Church  often  leave  the  sinner  in 
Jtate  of  unassuaged  personal  guilt  and  anguish. 

3.  Confession  is  not  an  adequate  deterrent.  This  criti- 
;m  is  most  often  heard  from  non-Catholics,  but  Catho- 
s  themselves  are  not  unaware  of  it  as  a  problem.  For 
ample,  a  young  priest  once  told  me  the  following  story, 

one  that  circulates  in  Catholic  circles.  A  peasant  went 
the  village  priest  and  said,  ''Father,  I  have  sinned." 
f'es,  my  son,"  came  the  reply,  "what  is  your  sin?" 
i'ather,"  said  the  peasant,  "last  night  I  stole  a  bale  of 
:aw.  No,  make  that  two  bales,  I  want  to  get  another 
le  tonight!" 

Those  who  have  been  caught  in  a  disgraceful  deed  or 
10,  from  bad  conscience,  have  had  to  make  a  painful 
nfession  thereof  know  that  having  one's  failures  and 
ortcomings  become  known  by  significant  others  is,  in 
ct,  an  extremely  powerful  corrective  of  behavior.  But 
e  fact  that  confession  is  not  expected  to  go  beyond 
e  priest  and  commonly  involves  a  mere  token  penance 
n  hardly  fail  to  limit  its  effectiveness  both  as  a  means 
assuaging  guilt  and  of  deterring  action  when  inner  con- 
3ls  are  weak. 

4.  Absolution  and  forgiveness  are  questionable  proce- 
ires.  Protestant  churches  do  not,  of  course,  lay  claim  to 
ipostolic  succession"  in  the  power  to  forgive  sins;  but 
ey  do  preach  a  doctrine  of  divine  forgiveness  and  ab- 
lution of  sorts.  Let  us  examine  this  concept  in  a  strictly 
iman,  interpersonal  light.  A  few  months  ago,  partly  as 


196  The  Crisis  in  Psychiatry  and  Religioi 

an  inadvertence  and  partly  out  of  slight  exasperation,  i 
made  a  very  unfortunate  remark  to  a  woman  of  my  ao 
quaintance.  I  immediately  realized  that  she  was  emba! 
rassed,  and  I  was  deeply  remorseful.  But  I  didn't  attempi 
any  sort  of  apology,  and  she  never  said  anything  in  th 
way  of  "forgiveness."  Nevertheless,  after  this  incideni! 
she  was  even  more  kindly  and  respectful  in  her  behavici 
with  me  than  she  had  been  before.  I  knew,  therefon: 
that  she  was  not  going  to  indulge  in  the  luxury  of  beinl 
resentful  toward  me  or  of  rebuking  me.  She,  manifestly! 
had  "forgiven"  me  in  the  sense  of  rising  above  the  incj 
dent  herself;  but  this  made  my  guilt  and  remorse  eve! 
greater,  not  less.  I 

This  incident  set  me  thinking  about  the  logic  and  ps;| 
chology  of  forgiveness  in  general.  How  can  another,  eitht 
in  a  religious  or  purely  personal  setting,  forgive  us?  ThI 
misdeed,  the  sin  is  ours;  and  who  would  presume,  an' 
whom  would  we  ask,  to  remove  this  responsibility?  If  wj 
have  erred,  do  we  not  wish  to  make  restitution,  insteai 
of  being  "excused"?  Forgiveness  in  the  usual  sense  of  th; 
term  is,  I  feel,  an  act  of  great  condescension  and  not  i\ 
all  likely  to  restore  either  our  self-respect  or  peace  (I 
mind.^ 

Therefore,  in  keeping  with  a  greater  emphasis  on  per 
ance  and  meaningful  restitution,  I  would  like  to  see  Pro; 
estant  churches,  as  they  reconsider  the  institution  of  cor 
fession,  stress  restitution  and  reform,  not  forgiveness.  I 
our  consciences  have  enough  rectitude  to  bother  us  whe 
we  act  badly,  I  believe  they  will  also  approve  and  suppo 
us  when  we  have  done  the  best  we  can  to  correct  oi 
misdeeds. 

Extensive  documentation  of  the  psychological  inad* 
quacy  of  religious  confession  and  assurance  of  forgivene 
as  commonly  practiced  is  not  readily  available.  But  Meel 
et  ah,  in  the  volume  already  cited,  related  the  followin 
incident: 

A  young  woman  confessed  that  she  had  broken  the  Se^ 
enth  Commandment  [Lutheran  numbering;  eighth  in  th 
Reformed  system]   by  pilfering  ribbons  and  socks  from 

*In  discussing  this  matter  with  a  colleague  recently,  I  wa 
much  interested  in  his  opinion  that  forgiveness  is  "a  profomr 
irrelevancy  in  human  affairs." 


i^ROTESTANTISM:    II.    CHALLENGE   AND    ChANGE  197 

dime  store.  She  was  obviously  contrite  about  the  transgres- 
sion, and  the  pastor  assured  her  of  God's  understanding  and 
gracious  forgiveness.  In  a  few  weeks  she  was  back  in  the  study 
to  confess  that  she  had  stolen  again,  this  time  a  few  cents 
from  her  mother's  purse.  Again  absolution  was  pronounced. 
When,  not  too  many  days  after  this,  the  girl  again  came  in 
tears,  the  pastor  began  looking  more  deeply.  Professional  help 
was  called  in  to  assist  the  girl.  Serious  deficiences  in  her 
home  life  were  uncovered.  It  became  apparent  that  she  had 
unexpressed  misgivings  about  whether  God  had  actually  for- 
given her  after  her  previous  confessions.  While  she  had  re- 
pented of  the  sin  that  she  knew,  she  recognized  her  inability 
to  straighten  herself  out;  this  feeling  created  internal  doubts 
about  her  confession.  As  these  feelings  were  brought  out  and 
she  began  to  understand  them,  the  urge  to  steal  waned — 
and  the  absolution  was  accepted  and  believed  (p.  284). 

Here  we  see,  first  of  all,  the  inadequacy  of  the  simple 
ormula  of  confession  and  assurance  of  divine  forgive- 
less.^  The  unfortunate  behavior  continued,  so  'Trofes- 
ional  help  was  called  in  to  assist  the  girl."  What  more 
eloquent  testimony  could  one  ask  of  the  loss  of  authority 
md  confidence  on  the  part  of  the  clergy  than  the  tend- 
;ncy  to  regard  secular  healers  as  the  "professionals"  in 
his  area?  If,  as  we  now  increasingly  suspect,  moral  issues 
ire  nuclear  to  every  neurosis,  isn't  it  remarkable  that  the 
:lergy  no  longer  regards  itself  as  first  in  competence  here? 
n  the  particular  instance  cited,  therapy  along  the  familiar 
ines  of  insight  and  understanding  was  ostensibly  suc- 
cessful. But,  in  the  large,  we  know  the  picture  is  not  a 
jood  one,  that  secular  therapy  predicated  on  the  common 
issumptions  about  repression,  mistreatment,  and  the  like 
iocs  not  have  a  reassuring  record;  and  this  is  why  there 
s  a  growing  feeling  that  we  should  re-examine,  revive, 
fnd  revise  the  institution  of  confession  so  as  to  make  it 
psychologically  and  ethically  more  meaningful  and  ade- 
|uate.  This,  it  seems,  is  a  challenge  that  is  pertinent  not 
)nly  to  the  Protestant  denominations  but  to  Catholicism 
[IS  well.^ 

^See  also  Weatherhead  (1957),  especially  Chapter  7,  on 
'The  Difficulty  of  Feeling  Forgiven." 

"A  recent  newspaper  report  indicates  that  the  Catholic 
phurch  has  under  consideration  a  proposal  to  increase  the 
everity  of  penances,  to  accord  with  earlier — ^and  probably 
oundei — ^practice. 


198  The  Crisis  in  Psychiatry  and  Religion 

V.   PROTESTANT    (aND   PSYCHIATRIC)    OBJECTIONS 
TO   THE   DOCTRINE   OF   GOOD   WORKS 
AND   RESTITUTION 

In  the  discussion  period  following  another  lecture,  I 
received  this  written  question  and  comment: 

How  would  you  interpret  Jesus'  reference  to  the  pharisees 
as  whited  sepulchres — outwardly  made  beautiful  and  inside, 
old  bones  and  dead  men's  bodies?  The  outward  beauty  ob- 
viously refers  to  the  pharisees'  assumed  goodness  and  the 
old  bones  and  dead  men's  bodies  must  refer  to  repression 
and  undeveloped  life. 

The  reference  is  here,  of  course,  to  Matthew  23:27; 
and  on  many  other  occasions  Christ  rebuked  the  Pharisees 
for  their  tendency  to  pray  and  give  alms  in  public  and 
otherwise  exhibit  their  piety.  'They  have  their  reward," 
was  his  summary  evaluation. 

Those  who  are  looking  for  it  can,  of  course,  easily  find 
here  an  apparent  repudiation  of  the  doctrine  of  good 
works.  But  how,  then,  are  we  to  interpret  the  story  of  the 
Good  Samaritan  and  dozens  of  other  similar  incidents 
reported  in  the  New  Testament?  No,  clearly  the  objec- 
tion is  not  to  good  deeds  as  such — far  from  it!,  but  to 
boasting  and  exhibitionism  with  respect  to  the  virtue  or 
credit  thus  achieved.  But  to  this  aspect  of  the  problem 
Christ,  himself  gave  the  solution:  when  you  perform 
charity,  do  it,  as  often  as  possible,  in  secret:  "Let  not 
your  left  hand  know  what  the  right  hand  doeth."  Is  this 
so  hard  to  understand  and  practice? 

As  if  the  Bible  itself  were  not  sufficiently  explicit  on 
this  score,  Lloyd  Douglas,  in  both  Magnificent  Obsession 
and   Doctor   Hudson's   Secret   Journal,    elaborates    and 
dramatizes  this  point  for  us  around  the  idea  that  reaL 
''power,"  as  he  calls  it,  comes  only  when  we  do  good: 
by  stealth.  Dr.  Hudson   (the  central  character  in  both| 
these  books)  holds  that  most  of  us  live  lives  which  are! 
blighted  by  chronic  insecurity,  doubt,  and  despair  because  \ 
we  characteristically  display  our  virtues,  and  good  deeds,  j 
and  hide  our  sins  and  shortcomings.  We  are,  so  to  say,^ 
chronically  in  debt  and  in  danger.  How,  then,  can  we 
resolve  the  situation?  It  is  obvious,  says  Dr.  Hudson:, 


'kotestantism:  ii.  Challenge  and  Change        199 

)isplay,  admit,  confess  our  sins  and  hide  our  good  works, 
uch  a  strategy,  he  argues,  helps  us,  slowly  but  surely,  to 
love  from  anxiety,  depression,  and  indecision  to  con- 
dence,  inner  strength,  and  joy — or,  as  he  calls  it, 
power." 

Another  argument  which  we  often  hear  in  this  connec- 
ion  is  this:  "But  many  of  our  sins  are  of  such  a  nature 
iat  we  carCt  atone  for  them."  This,  in  the  literal  sense, 
;,  to  be  sure,  often  true.  But  we  can  try — and  if  we 
ersevere  long  enough,  knock  hard  enough,  the  door 
ventually  opens.  The  atonement  or  restitution  doesn't, 
f  course,  have  to  be  "in  kind,"  i.e.,  made  precisely  to  the 
erson  who  has  been  wronged  or  hurt,  or  be  precisely  on 
le  point  of  the  original  misdeed.  There  is  always  need 
3r  service  of  other  kinds  in  the  world;  and  who  is  to 
ly  that  sacrifice  for  a  good  cause  is  less  worthy  as  "justifi- 
ation"  than  is  a  specific  reparation? 

Sometimes  psychologists  and  psychiatrists  who  do  per- 
3nnel  assessment  work  for  seminaries  and  mission  boards 
'ill  damn  a  candidate  on  the  grounds  that  he  is  "moti- 
ated  by  personal  guilt."  Is  this  necessarily  bad?  How 
lany  men  and  women,  one  wonders,  have  saved  them- 
dves  from  mental  illness  or  worse  by  this  very  device? 
'he  important  thing,  I  suspect,  is  that  the  individual  be 
lear-headed  about  what  he  is  doing  and  why  he  is  doing 
:.  If  these  conditions  are  met,  I  should  be  inclined  to 
xpect  such  a  motivation  to  augur  for  success  rather  than 
le  reverse.  What  other  type  of  motivation  would  we  re- 
ard  as  sounder?  Or  what  better  means  of  dealing  with 
ersonal  guilt  would  we  suggest? 

Of  course,  the  whole  idea  of  atonement  is  foreign  to 
ur  modern  way  of  thinking  about  personality  disturb- 
nces.  Such  disturbances,  we  have  been  told  and  told 
gain,  come  from  false  guilt,  from  lack  of  insight,  from 
ver-conscientiousness;  so  what  is  there  to  confess,  much 
jss  realistically  atone  for?  The  "need  for  punishment" 
1  neurotic  individuals  has,  of  course,  long  been  recog- 
ized;  but  it  has  been  largely  dismissed  as  the  "masochis- 
ic"  aspect  of  neurosis  itself.  In  other  words,  it  too  was 
2en  as  irrational,  a  form  of  sickness  rather  than  a  sensible 
nd  healthy  striving  toward  wholeness. 

But  the  times  are  changing.  Recently  The  Psychiatric 
'bulletin  of  the  University  of  Texas  carried  a  feature 


200  The  Crisis  in  Psychiatry  and  Religion 

article  entitled  "Retribution  and  Neurosis,"  the  introduc- 
tory paragraph  of  which  reads  as  follows: 

In  many  kinds  of  emotional  illness  or  maladjustment,  guilt, 
whether  conscious  or  unrecognized,  coexists  with  an  assump 
tion  of  punishment.  Sometimes  any  disorder  or  event  is  inter 
preted  as  such.  Patients  may  feel  doomed  or  fated  to  undergo 
some  tragedy  or  committed  to  a  course  of  action  that  wil 
culminate  in  disaster.  Others  may  explain  a  chronic  illnes! 
or  develop  a  functional  one  as  a  retributive  measure.  Twc 
related  versions  of  this  manifestation  are  described  as  the 
talion  principle  and  the  nemesis  concept  (p.  16). 

There  then  follows  a  discussion  of  the  talion  anc 
nemesis  principles,  which  I  assume  are  well  known.  Bui 
in  a  section  entitled  "Treatment,"  a  new  note  is  struck 
Here  there  is  no  reference  to  the  classical  Freudian  doc 
trine  of  false  guilt  as  basic  to  neurotic  difficulties.  In 
stead  we  read: 

Patients  may  be  anxious,  phobic,  or  obsessive,  for  example 
but  their  basic  fear  is  also  their  method  of  coping  with  th( 
discomfort  caused  by  their  unresolved  guilt. 

And  in  conclusion  the  author  says : 

A  nineteenth-century  physician  Abraham  Coles,  wrote  o 
"the  inappeasable  Nemesis  within."  He  was  speaking  of  th( 
guilty  conscience.  In  this  way  the  individual  meets  his  owi 
guilt  feelings;  ideas  of  retribution  may  figure  strongly.  Patient 
require  psychotherapeutic  help,  both  for  their  psychosomatii 
ailments  and  for  alleviation  of  such  fears  as  may  be  explainec 
away.  In  obsessional  cases  or  in  severe  instances  in  which  thi 
concept  of  retribution  affects  all  phases  of  the  patient's  living 
referral  for  psychiatric  treatment  is  needed  (p.  17). 

If  the  reader  senses  some  ambiguity  here,  it  will  not  b( 
surprising.  What  is  the  author  really  saying?  On  the  on( 
hand,  he  seems  to  be  saying,  or  at  least  implying,  that  ii 
neurosis,  guilt  is  (always?)  real,  with  a  justifiable  expecta 
tion  of  impending  punishment  or  retribution  of  som( 
sort.  But  also  he  is  suggesting  that  such  fears  may  some 
times  be  "explained  away";  and  if  not,  that  they  can  b( 
dealt  with  by  established  psychiatric  methods.  It  is  no 
clear  what  methods  modern  psychiatry  has  for  dealing 
with  real  guilt.  But  the  title  of  this  article  at  least  carrie: 
the  implication  that  restitution  might  be  an  alternative 


Protestantism:  ii.  Challenge  and  Change        201 

0  the  retribution  which  is  often  associated  with  neurotic 
endencies.  Here  is  a  new  trend  in  contemporary  psy- 
chiatric thought,  which  is  further  underscored  by  the 
following  lines,  quoted  by  the  author,  from  Byron's 
'Childe  Harold's  Pilgrimage": 

Meantime  I  seek  no  sympathies,  nor  need; 
The  thorns  which  I  have  reap'd  are  of  the 

tree 
I  planted, — they  have  torn  me — and  I 

bleed; 
I  should  have  known  what  fruit  would 

spring  from  such  a  seed. 

It  sounds  as  if  at  least  some  psychiatrists  are  beginning 
:o  take  guilt  seriously.  This  is  a  hopeful  and  constructive 
}ign. 

VI.  confession:  sacrament  or  therapy? — 

THE   catholic   POSITION 

i 

In  the  Catholic  Church,  confession  and  the  associated 
acts  of  contrition  and  attrition  (remorse  and  penance) 
are  first  and  foremost  a  sacrament:  means,  that  is,  of 
bringing  one's  immortal  soul  from  a  state  of  sin  to  grace 
and  thus  averting  the  dangers  of  Hell.  But  on  the  ques- 
tion of  whether  confession  is  also  emotionally  and  psy- 
chologically helpful  in  this  life,  the  Church  is  officially 
silent,  with  the  views  of  individual  Catholic  writers  cov- 
ering the  full  spectrum  from  strong  affirmation  to  em- 
phatic denial. 

If  present  presuppositions  are  valid,  confession  and 
jpenance  should — and  in  many  instances  rather  clearly  do 
! — ^have  a  genuinely  hygienic  effect,  limitations  in  the 
|Catholic  system  notwithstanding.  And  among  those  who. 
Within  the  Church,  emphasize  this  aspect  of  the  practice, 
inone  is  more  urgent  and  eloquent  than  Father  Alfred 
fWilson,  C.  P.,  in  his  book  Pardon  and  Peace  (1954). 
IWorthy  of  close  study  in  its  entirety,  this  work  (''Nihil 
'obstaf')  can  here  be  considered  only  in  the  most  cursory 
fashion.  But  the  author,  having  paid  his  respects  to  the 
sacramental  aspect  of  confession,  comes  quickly  and 
'clearly  to  his  central  thesis,  which  is  that  confession  is 
unmistakably  and  powerfully  therapeutic.  He  says: 


202  The  Crisis  in  Psychiatry  and  Religion 

Our  unfortunate  non-Catholic  brethren  do  not  know  what 
they  are  missing,  and  little  realize  the  blessings  that  heresy 
has  snatched  from  them  (p.  2). 

No  one  goes  to  the  doctor  or  the  dentist  for  fun,  unless 
he  is  mad.  No  one  goes  to  Confession  for  fun.  From  the  na- 
ture of  the  case,  confession  cannot  be  easy.  The  result,  not 
the  process,  of  confession  is  consoling. 

After  serious  sin,  however,  we  have  no  alternative  but  to 
confess  if  we  desire  to  regain  undisturbed  peace  of  mind 
and  safeguard  our  sanity.  We  must  lift  the  burden  from  our 
minds,  or  become  a  burden  to  ourselves  and  risk  becoming 
a  burden  to  others.  Confession  is  then — if  you  like  to  put 
it  that  way — the  lesser  of  two  evils  (p.  3). 

Why  is  this  relief  necessary?  Why  must  we  tell  our  misery 
to  at  least  one  representative  of  the  human  race?  Because 
until  we  confess  we  feel  hypocrites.  We  feel  that  we  are 
being  taken  for  a  hundred  percent  good  and  we  know  we 
are  not.  We  feel  that  we  are  obtaining  respect  and  love  un- 
der false  pretences.  If,  however,  we  can  find  one  member 
of  the  human  race  who  will  listen  to  us  sympathetically,  who 
can  know  the  worst  and  still  respect  and  love  us,  we  feel  that 
our  self-respect  and  social  status  are  somehow  restored.  We 
can  then  reasonably  hope  for  the  respect  of  our  fellow-men, 
despite  our  fault. 

Sin  sets  up  in  the  mind  a  conflict  between  our  self-respect 
and  our  social  sense.  That  conflict  can  be  terminated  only 
by  some  form  of  confession.  "Confess,  therefore,  your  sins 
one  to  another  that  you  may  be  healed"  (p.  5). 

There  then  follow  some  well-chosen  phrases  especially 
meant  for  Protestant  ears: 

Confession  is  the  only  remedy.  It  is  no  use  to  say,  as  many 
non-Catholics  do:  *'I  confess  my  sins  directly  to  God,  and 
that  is  quite  good  enough  for  me."  First  of  all,  it  is  the 
common  experience  that  confession  to  God  alone  does  not 
bring  the  fullest  measure  of  relief  of  mind.  It  is  no  argument 
against  this  to  say  that  it  is  not  your  experience.  It  is  the 
common  experience,  and  it  is  safe  to  presume  that  Christ 
legislated  for  the  rule  and  not  the  exception. 

In  any  case,  adequate  mental  readjustment  after  sin  re- 
quires readjustment  of  our  relations  with  our  fellow-men  as 
well  as  with  God.  If  you  insult  a  friend,  it  is  not  enough  to 
apologize  to  God — ^you  must  apologize  to  your  friend  as  well. 
.  .  .  Sin  is  an  offense  against  society  as  well  as  against  God, 
and  for  both  offenses  adequate  reparation  must  be  made.  .  .  . 

All  these  unrealists  (who  pout  incessantly  and  suspiciously 


Protestantism:  ii.  Challenge  and  Change        203 

about  their  realism)   are  heading  for  a  nervous  breakdown 
(p.  6). 

And  then,  again  in  a  more  general  vein,  Father  Wilson 
continues: 

Confession  of  serious  sin  is  necessary  for  the  restoration 
of  health  of  mind  and  soul,  redundantly,  even  for  health 
of  body.  "Suppressed  sin,  like  suppressed  steam,  is  dangerous. 
Confession  is  the  safety-valve"  (Weatherhead,  1929,  p.  88). 

Modern  psychologists  have  rediscovered  this.  They  have 
found  from  practical  experience  that  many  nervous  break- 
downs can  be  traced  to  a  sense  of  guilt  from  unconfided  and 
unforgiven  sins  (p.  8). 

I  don't  think  the  majority  of  Catholics  realize  how  much 
they  owe  to  the  Sacrament  of  Penance.  One  of  the  greatest 
of  Viennese  psychologists,  a  man  bitterly  anti-Catholic  [pre- 
sumably Freud],  had  the  honesty  to  admit  that,  among  his 
cases  of  serious  psychological  disorder,  he  had  never  had 
a  genuinely  practising  Catholic  (p.  10). 

Now,  in  stark  contrast,  we  turn  to  a  recent  article  by 
father  Richard  P.  Vaughn,  S.  J.,  entitled  "Mental  Illness 
mong  Religious."  Here  the  whole  emphasis  of  the  Wil- 
on  book  upon  the  relationship  between  unredeemed  sin 
nd  emotional  disturbance  is  flatly  repudiated: 

In  spite  of  research  data  to  the  contrary,  there  still  persists 
a  vague  suspicion  that  mental  illness  is  in  some  way  con- 
nected with  a  sinful  life  or  at  least  that  it  cannot  occur  if  a 
person  is  leading  a  truly  holy  life. 

A  psychosis  is  a  type  of  sickness,  just  as  are  ulcers  of  the 
stomach  or  cirrhosis  of  the  liver.  Whether  the  cause  of  the 
psychotic  condition  is  psychological  or  organic  or  a  combina- 
tion of  both  (which  is  more  likely)  has  not  yet  been  estab- 
lished. It  can,  however,  safely  be  stated  that  a  psychosis 
(with  the  exception,  perhaps,  of  a  condition  brought  on  by 
alcoholism  or  drug  addiction)  is  not  the  result  of  a  sinful 
life.  The  idea  that  it  is  the  effect  of  sin  is  simply  a  remnant 
of  past  attitudes  which  still  prevail  from  an  era  when  little 
was  known  about  psychiatry  and  psychology.  The  fact,  there- 
fore, that  a  religious  person  becomes  psychotic  does  not  in 
any  way  imply  past  moral  indiscretions.  Religious,''  even 
though  they  follow  a  more  perfect  way  of  hfe,  are  no  more 

'  "Religous"  is  the  Catholic  term  for  persons  who  have  taken 
loly  Orders. 


204  The  Crisis  in  Psychiatry  and  Religion 

immune  from  severe  mental  illness  than  the  average  lay  per- 
son (pp.  27-28). 

What  a  remarkable  exhibit!  Despite  the  ancient  and 
widespread  folk  belief  that  there  is  a  connection  between 
moral  integrity  and  psychological  integration,  and  despite 
the  obvious  advantage  which  accrues  to  Catholicism  if  it 
can  be  successfully  maintained  that  confession  is  mentally 
hygienic  (as  well  as  sacramental),  here  is  a  Jesuit  se- 
riously and  insistently  arguing  against  this  position.  The 
reason  for  his  discomfiture  is,  however,  not  far  to  seek: 
it  is  impossible  to  verify  the  effectiveness  or  ineffective- 
ness of  confession  as  a  sacrament,  and  the  Church  can 
continue  to  make  great  metaphysical  claims  for  it  without 
fear  of  empirical  refutation;  but  as  soon  as  one  makes  a 
claim  for  confession  as  an  instrument  of  either  preven- 
tion or  treatment,  such  a  claim  immediately  becomes 
susceptible  to  empirical  check — and  it  is  already  known 
that  the  facts  on  this  score  are  somewhat  ambiguous. 
Wilson,  as  we  have  seen,  implies  that  confession,  as  pre- 
scribed by  and  practiced  within  the  Church,  is  virtually 
a  panacea  as  far  as  emotional  and  psychological  disturb- 
ances are  concerned;  whereas  Vaughn  is  equally  emphatic 
and  categorical  in  holding  that  there  is  no  connection  here 
at  all!  The  truth  probably  lies  somewhere  in  between;  but 
with  its  doctrine  of  infallibility,  the  Church  must,  of 
course,  take  an  all-or-none  position — partially  effective 
measures  not  being  admissible.  Yet,  as  it  functions  today, 
confession  apparently  has  precisely  this  status,  psychologi- 
cally speaking:  although  it  is  or,  at  least  under  the  most 
favorable  conditions,  can  be  a  decided  aid  to  mental 
health,  the  mere  formal  observance  of  the  rules  govern- 
ing confession  is  no  guarantee  thereof;  and  the  Church, 
some  v^iters  apparently  feel,  cannot  afford  to  lay  claim 
to  any  power  which  is  not  absolute. 

The  situation  is  further  illuminated  if  we  note  that  in 
writing  for  and  about  religious  laymen,  as  Father  Wilson 
obviously  did,  it  can  always  be  argued  that  if  a  Catholic 
encounters  intractable  emotional  difficulties,  this  is  be- 
cause he  has  in  some  vital  respect  failed  as  a  Catholic — 
and  I  am  personally  persuaded  that  there  is  some  merit  in 
this  argument.  But  once  a  man  or  woman  has  taken  Holy 
OrderSf  the  situation,  per  theory  at  least,  is  importantly 


Protestantism:  ii.  Challenge  and  Change        205 

modified.  Here  are  the  best,  "the  religious/*  an  elite 
guard,  in  whom  human  frailties  have  been  all  but  van- 
quished; and  the  fact,  indeed  prevalencey  of  serious  men- 
tal disorder  among  monastics  (especially  women)  is  well 
established  (cf.  Moore,  1936) .  This  problem  is,  indeed,  so 
serious  that  Father  Vaughn  pleads  for  ''psychological 
screening"  of  individuals  entering  the  orders: 

Many  a  community  has  spent  thousands  of  dollars  for  the 
hospitalization  of  a  single  psychotic  member,  and  this  at  con- 
siderable sacrifice  to  the  other  members  of  the  community. 
And  then  after  all  this  expense,  it  not  infrequently  happens 
that  the  religious  is  finally  diagnosed  as  incurable.  In  such 
cases  one  might  well  ask  whether  such  a  diagnosis  would 
have  been  reached  if  the  psychotic  religious  had  never  been 
subjected  to  the  strain  and  disillusionment  of  the  religious 
life  (p.  29). 

Here  is  an  oblique  admission  that  at  least  for  those 
entering  the  special  orders,  Catholicism,  far  from  being 
therapeutic,  may  have  exactly  the  opposite  influence.  It 
is  little  wonder,  therefore,  that  this  whole  matter  is  at 
present  a  very  painful  and  confusing  one  for  the  Church, 
from  top  to  bottom.  The  ambiguity  of  the  situation  is,  in 
fact,  excellently  portrayed  by  a  current  article  on  "Sin, 
Sickness,  and  Psychiatry,"  by  John  R.  Connery,  S.  J., 
which  appears  in  America,  the  official  Jesuit  journal  of 
opinion  and  controversy.  Here  the  author  says,  by  way  of 
introduction : 

The  various  aspects  of  this  conflict  are  best  illustrated  in 
the  different  opinions  advanced  regarding  the  relationship 
between  sin  and  mental  sickness.  Besides  the  opinion  that 
would  regard  sin  as  sickness  rather  than  an  expression  of  the 
will  of  the  sinner,  there  is  a  second  opinion  that,  surprisingly, 
reverses  the  relationship.  According  to  this  opinion,  sin,  far 
from  being  the  result,  is  really  the  cause  of  mental  illness.  A 
third  opinion  refuses  to  consider  sin  either  as  cause  or  effect 
of  mental  illness,  but  tends  to  regard  it  as  the  cure  (p.  493). 

It  is,  of  course,  not  surprising  that  the  author  of  this 
article  should  reject  the  first  and  third  of  these  hy- 
potheses. The  Church,  obviously,  cannot  concede  either 
that  sin  is  an  expression  of  psychopathology  or  that  it  is 
a  cure  thereof  ["Have  an  affair!"  "Act  single!"  cf.].  It 
is,  of  course,  the  second  possibility,  namely  that  uncon- 


206  The  Crisis  in  Psychiatry  and  Religion 

fessed  and  unexpiated  sin  is  the  cause  of  psychopathology 
that  gives  Cathohc  theorists  the  difficulty.  Connery  ad- 
mits that: 

It  is  quite  true  that  the  act  of  confessing  one's  sins,  the 
acceptance  of  the  priest  and  of  his  pastoral  counsel  can 
have  some  therapeutic  value,  but  this  is  not  the  primary  pur- 
pose for  which  the  sacrament  was  instituted.  The  sacrament 
of  penance  is  primarily  a  sacrament  of  forgiveness  (p.  493). 

Then  the  author  tries  to  come  more  specifically  to  grips 
with  the  hypothesis  that  "neurosis  must  be  traced  to 
sin."  He  says: 

According  to  this  opinion,  it  is  because  the  patient  has 
repressed  his  conscience,  rather  than  because  he  has  repressed 
his  instinctive  drives,  that  he  develops  a  neurosis.  Although 
this  position  is  held  by  some  first-rate  psychologists  and  psy- 
chiatrists, it  is  vigorously  opposed  by  equally  competent  repre- 
sentatives of  these  fields.  From  a  religious  viewpoint  it  does 
not  have  the  objectionable  features  of  the  opinions  already 
considered,  but  it  is  not  necessarily  true  because  it  is  reli- 
giously more  agreeable.  There  are,  indeed,  good  reasons  for 
questioning  it.  First  of  all,  there  are  many  habitual  sinners 
who  to  all  appearances  have  average  mental  and  emotional 
balance.  Secondly,  the  scrupulous  conscience,  which  usually 
must  be  classified  as  neurotic  to  some  degree,  does  not  ordi- 
narily have  its  origin  in  past  sin.  For  the  most  part,  the  scru- 
pulous individual  is  as  remote  from  sin  as  one  can  get  (p. 
495). 

This  is  an  incompetent  and  irresponsible  statement. 
The  argument  that,  because  all  persons  w^ho  are  sinners 
are  not  mentally  disturbed,  there  is  no  relation  at  all  be- 
tween sin  and  insanity  is  a  classical  non  sequitur  which 
I  have  discussed  elsewhere  [Chapter  1 3] .  And  in  the  same 
connection  I  have  cited  evidence  (as  well  as  another 
Catholic  authority— Stafford,  1950)  for  the  view  that 
scrupulosity  is  a  neurosis  precisely  because  the  individual 
so  afflicted  prefers  this  symptom  to  an  honest  and  thor- 
oughgoing confession. 

No,  the  plain  truth  is  that  most  Catholic  writers  do 
not  wish  to  recognize  neurosis  as  a  basically  moral  and 
social  problem,  because  they  realize  that  to  do  so  raises 
embarrassing  questions  concerning  the  adequacy  of 
Catholic  doctrine  and  practice,  thus  underscoring  the 


Protestantism:  ii.  Challenge  and  Change        207 

specific  limitations  and  criticisms  which  I  have  enumer- 
ated in  Section  IV.  Here,  therefore,  is  a  wonderful  op- 
portunity and  challenge  to  other  religious  groups:  to 
develop  ways  of  dealing  with  personal  guilt  which  are 
genuinely  adequate,  psychologically  and  ethically,  and 
which  do  not  retreat  into  the  realm  of  metaphysical 
claims  which  defy  verification.  It  is  also  an  opportunity 
for  Catholicism  to  take  stock  of  itself  and  institute  some 
long  overdue  reforms. 


A  curious  but  not  uninstructive  drawing  accompanies 
the  article  by  Father  Connery,  which  is  also  reproduced 
here.  What  does  it  mean?  I  hold  it  expresses  the  am- 
biguity, the  confusion,  the  sickness  of  the  contemporary 
Catholic  position  in  this  whole  matter  of  sin  and  psy- 
choneuroses.  The  figure,  ostensibly  a  monk,  is  caught  in 


208  The  Crisis  in  Psychiatry  and  Religion 

a  posture  which  is  both  rehgious  and  schizophrenic.  The 
Church,  which  has  a  conscience,  is  sore  afflicted  because 
it  is  refusing  to  minister  to  anxious,  depressed  people  for 
fear  of  compromising  or  having  to  modify  its  doctrinal 
pretensions.  If  the  Church  is  so  rigid  and  fixated  that  it 
cannot  act  as  a  physician  to  itself,  the  necessary  accom- 
modations and  changes  must  be  made,  as  before,  outside 
the  Church. 

Vn.   STRAWS  IN  THE   WIND:    A  CASE  HISTORY 

With  issues  as  global  and  controversial  as  those  with 
which  we  have  dealt  in  these  two  lectures,  it  is  easy  to 
doubt,  at  times,  the  validity  of  one's  most  basic  assump- 
tions. There  is  no  simple,  direct  way  of  testing  or  demon- 
strating them — to  others  or,  indeed,  to  oneself;  and  when 
they  represent  a  marked  departure  from  ordinary  beliefs, 
one  wonders,  occasionally,  if  they  may  not  be  sheer 
fantasy.  There  is,  however,  a  stark  reality  to  which  I 
return  in  my  doubting  and  always  find  grimly  reassuring. 
In  an  era  in  which  physical  disease  has  been  spectacularly 
reduced,  the  indices  of  personality  disorder,  by  contrast, 
have  steadily  risen.  In  the  two  decades  between  1934 
and  1954,  the  death  rate  in  this  country  declined  13.6% 
(Fagley,  1960,  p.  29);  but  during  this  same  period  the 
likelihood  of  one's  spending  some  part  of  his  life  in  a 
mental  hospital — the  abode  of  the  ^'living  dead" — rose 
from  about  one  in  20  to  one  in  10.  The  evidence  that 
prevailing  views  and  practices  in  this  area  are  seriously 
inadequate  is  thus  compelling.  And  at  least  small  signs 
keep  emerging  which  point  in  the  direction  of  alternatives 
which  seem  more  promising. 

Following  a  lecture  which  I  gave  a  few  months  ago  in 
a  city  in  Northern  California,  a  diffident  but  obviously 
intelligent  middle-aged  woman  approached  me  and  said 
that  she  thought  I  might  like  to  know  that  the  Church 
of  the  Latter  Day  Saints  has  always  placed  a  great  deal 
of  emphasis  upon  good  deeds — in  contrast  to  the  Pauline 
doctrine  of  justification  by  faith — and,  as  a  result,  has 
been  a  constant  target  for  criticism  by  Protestant  the- 
ologians. This  bit  of  information  did  indeed  interest  me; 
and  somewhat  later  I  happened  to  mention  it  to  a  social 
worker  who,  himself  a  Mormon,  volunteered  the  addi- 


Protestantism:  ii.  Challenge  and  Change        209 

tional  information  that  his  rehgion  sets  aside  one  Sunday 
each  month  for  open  confession.  Then  he  mentioned  a 
case  history  recently  reported  to  him  by  a  non-Mormon 
chnical  psychologist  known  to  both  of  us  which  indicates 
the  possible  therapeutic  effectiveness  of  the  Mormon  ap- 
proach in  these  matters.  I  immediately  wrote  for  further 
details;  and  the  psychologist  obligingly  supplied  a  copy 
of  the  "Social  Service  Intake"  record  and  of  his  own 
"Termination  Note."  The  first  of  these  documents  reads 
as  follows: 

This  21 -year-old  female  is  referred  by  Dr.  because 

of  anxiety  over  sexual  adjustment,  brought  about  by  long- 
standing unsatisfactory  sexual  relationships  with  her  father. 
She  is  a  rather  large,  plump  girl  who  brings  a  long  tale  of  se- 
duction and  mistreatment  by  her  father  since  approximately 
age  7.  She  is  not  a  particularly  verbal  girl,  and  did  not  volun- 
teer much  during  the  interview.  She  has  been  going  with  a  boy 
for  approximately  six  months,  has  thought  of  marriage,  but 
is  physically  repelled  by  him.  She  states  that  sex  is  associated 
in  her  mind  with  sin  and  pain,  and  that  she  would  like  help 
to  relieve  these  feelings.  Her  conversation  was  flat  and  unemo- 
tional throughout  the  interview,  and  she  has  a  rather  placid, 
unemotional  face. 

Patient  is  the  oldest  of  four  children,  having  a  full  sister, 
a  half  sister,  and  a  half  brother.  The  patient's  mother  died 
when  she  was  four  years  of  age  and  the  father  remarried 

about  four  years  later. is  a  daughter  by  the  stepmother's 

first  marriage,  and is  a  son  by  the  present  mother  and 

father. 

The  patient  states  that  the  father  has  forced  sexual  rela- 
tionships on  her  and  her  two  sisters  since  the  patient  was  7 
years  of  age,  that  he  has  been  extremely  abusive  toward  her, 
that  he  has  never  shown  any  affection  except  when  sexually 
aroused,  and  that  she  has  come  to  think  of  men  as  being 
brutal  persons  who  want  nothing  but  physical  satisfaction 
from  their  women.  She  was  particularly  irked  by  the  fact 
that  her  father  played  favorites,  and  was  frequently  quite 
seductive  toward  her  sisters  in  her  presence.  She  has  tried  to 
work  out  her  problems  with  her  boy  friend's  help,  but  feels 
intensely  frigid  toward  him  when  he  becomes  affectionate. 
I  Her  general  attitude  toward  sex  has  been  that  it  is  dirty,  and 
j  it  has  been  with  effort  that  she  has  associated  with  boys, 
usually  preferring  and  feeling  more  comfortable  with  girls  as 
friends. 

Currently,  the  father  is  at  Psychopathic  Hospital 

undergoing  psychiatric  evaluation,  since  the  girls  filed  a  com- 


210  The  Crisis  in  Psychiatry  and  Religion 

plaint  with  the  County  Insane  Commission.*  The  patient 
reports   that  he  has  been   increasingly  abusive,   suspicious, 
jealous,  and  demanding  of  his  daughters.  Matters  reached  a 
head  this  spring  when  the  patient  returned  from  her  third  i 
year  of  college  and  refused  her  father's  advances.  Currently,] 
the  stepmother  is  attempting  to  defend  him  legally.  Thej 
patient's  impression  is  that  the  stepmother  has  known  about  j 
these  affairs  for  many  years,  but  that  she  has  not  wanted' 
to  do  anything  about  them.  i 

IMPRESSIONS  AND  RECOMMENDATIONS:  This  girl  Certainly' 
has  problems  connected  with  a  long-term  unsatisfactory  rela- 
tionship with  her  father.  It  is  understandable  that  she 
should  equate  sex  with  brutality,  and  that  there  should  be  a 
distortion  in  her  relationship  with  men.  Significantly,  she 
suspects  men  of  seductive  motivations  to  the  extent  that  she 
expressed  a  fear  that  I  might  attempt  to  "seduce"  her.  It 
had  not  occurred  to  her  that  such  a  possibility  in  a  setting 
like  this  would  be  totally  unrealistic.  There  is  a  question  in 
my  mind  in  regard  to  her  motivation  for  therapy,  but  this 
impression  may  be  imposed  by  her  rather  flat  manner  and 
affects.  The  patient  should  be  seen  for  psychiatric  evaluation, 
and  should  probably  be  scheduled  for  full  psychological  ex- 
amination at  an  early  date.  This  does  not  appear  to  be  an 
emergency  case,  and  could  be  placed  on  our  waiting  list 
following  the  diagnostic  studies. 

Executive  Director 

*  The  father  was  given  a  long  prison  sentence  subsequent  to 
this  evaluation. 

This  case  has  many  interesting  implications  and  is 
especially  pertinent  to  the  present  discussion.  It  is  clear 
that  this  young  woman's  guilt  concerning  the  incest 
was  a  barrier  to  normal  marriage  and  that  her  coming  to 
the  clinic  was  prompted  by  the  fact  that  she  had  become 
of  marriageable  age  and  had  some  prospects.  She  felt — 
quite  understandably — that  she  could  not  get  married 
with  the  incest  on  her  conscience;  and  she  was  forthright 
in  saying  that  she  * 'would  like  help  to  relieve  these  feel- 
ings." 

The  intake  worker  reports  that  the  client — ^let  us  call 
her  Marie — "has  come  to  think  of  men  as  being  brutal 
persons  who  want  nothing  but  physical  satisfaction  from 
their  women,"  thus  implicitly  shifting  blame  and  partially 
rationalizing  her  own  conduct^and  somewhat  becloud- 


Protestantism:  ii.  Challenge  and  Change        211 

ing  the  reason  why  she  can't  get  married.  But  if  there 
were  not  deep  guilt  and  self-rejection  in  the  situation, 
it  seems  that  the  early  introduction  to  sex  and  prolonged 
experience  with  it  would  have  paved  the  way  for  con- 
tinuation with  others.  Instead,  *'sex  is  associated  in  her 
mind  with  sin  and  pain."  Also  it  is  noteworthy  that 
Marie,  while  intimating  that  the  stepmother  knew  of  the 
incest,  gives  no  indication  of  ever  having  appealed  to 
her  for  help.  If  there  had  been  no  complicity  in  the 
situation,  it  seems  there  would  have  been  a  complaint 
or  protest,  to  someone! 

On  another  occasion  [Chapter  8],  I  have  discussed 
the  deep  incest  guilt  of  a  schizoid  girl  known  as  Joan. 
But  in  situations  where  frank  psychopathology  is  present, 
a  skeptic  can  always  dismiss  the  incest — and,  therefore, 
real  guilt  as  the  cause  of  the  "illness" — as  a  fabrication 
or  "delusion"  or  can  interpret  the  act,  if  real,  as  an  early 
expression  of  the  disease  itself.  (In  fact,  the  counselor 
who  initially  reported  the  Joan  case,  anonymously,  has 
recently  written  to  me  and  expressed — apparently  for 
theoretical  rather  than  empirical  reasons — some  doubt  of 
the  validity  of  Joan's  report  of  the  experiences  with  her 
father. )  But  in  the  present  situation,  there  is  no  question 
of  "schizophrenia"  or  any  other  well  developed  mental 
disease;  and  the  fact  of  the  incest  seems  established 
beyond  doubt  (cf.  the  prison  term  given  to  the  father 
for  the  offense).  Hence,  the  "dynamics"  of  the  case  seem 
particularly  clear,  unambiguous,  and  instructive. 

Let  us  now  examine  the  "Termination  Note"  dictated 
and  generously  provided  by  the  psychologist  to  whom 
Marie  was  assigned: 

Marie  was  referred  by  Dr.  in  September,  1957,  be- 
cause of  extreme  fears  regarding  sexual  relations,  in  part 
stemming  from  long-term  incestuous  relations  with  her  father. 
She  was  seen  for  a  total  of  12  interviews  (primarily  psy- 
chotherapeutically)  from  November  31,  1957,  to  April  19, 
1958.  Marie  is  being  terminated  since  she  will  be  leaving  for 

to  obtain  work  and  probably  resume  College  after  a 

while. 

Marie  had  a  very  strong  fear  of  the  close  relationship  with 
a  man  in  psychotherapy  which  resulted  in  her  extreme  tension 
with  me  at  the  beginning  of  the  treatment  process,  wanting 
to  quit  treatment  several  times,  and  finding  different  excuses 
not  to  make  regularly  scheduled  appointments.  At  first  my 


212  The  Crisis  in  Psychiatry  and  Religion 

interest  in  her  was  interpreted  by  her  as  having  sexual  imphca- 
tions.  Slow  and  careful  work  with  her  resulted  in  excellent 
progress  for  the  relatively  few  short  interviews  considering 
the  nature  of  her  problem.  Marie  has  begun  to  show  greater 
initiative  and  less  extreme  submissiveness;  there  was  a  definite 
decrease  in  her  extreme  feelings  of  being  "so  different  and 
so  inadequate,"  now  she  can  allow  herself  to  try  many  things, 
whereas  before  she  would  have  been  convinced  prior  to  any 
attempt  that  she  could  not  accomplish  the  task.  There  was 
the  beginning  of  a  greater  feeling  of  being  at  ease  with  all 
people  including  men,  plus  less  sinful  and  guilty  feelings  re- 
garding sex.  She  was  able  to  lose  weight  more  quickly  than 
ever  before  in  her  life,  probably  a  reflection  of  her  decrease 
in  fear  of  being  attractive  to  men. 

However,  though  the  progress  was  excellent,  it  is  felt  that 
much  more  psychotherapy  need  be  undertaken  prior  to  her 
ability  to  deeply  enjoy  a  close  relationship  with  a  man,  such 
as  in  marriage.  We  had  just  begun  to  directly  work  on  the 
very  disturbing  sexual  area  when  Marie  got  this  fine  oppor- 
tunity to  go  to and  live  with  persons  whom  she  felt  at 

home  with  in  her  new-found  religion,  that  of  the  Latter-Day 
Saints. 

Her  definite  need  for  further  treatment  when  she  gets  to 

appeared  to  be  fairly  well  emotionally  accepted  by 

Marie.  Perhaps  more  than  any  insight,  the  one  thing  that 
was  most  helpful  to  her  was  the  beginning  of  the  develop- 
ment of  some  deep  trust  in  one  man.  However,  whoever 
works  with  her  in  psychotherapy  should  anticipate  a  pretty 
stormy  relationship  with  her,  including  such  things  as  want- 
ing to  terminate  treatment  many  times,  and  finding  excuses 
for  not  coming  to  interiews. 
TYPE  OF  service:  Diaguosis  and  treatment. 
CONDITION  ON  TERMINATION:  Improved. 
diagnosis:  Phobic  reaction  (intense  fear  of  close  relationship 
with  all  men)  in  a  passive-aggressive  personality,  passive- 
dependent  type. 
disposition:   Patient  withdrew  from   Clinic  service.   Clinic 

notified,  (moved) 
prognosis:  Good  for  continuation  of  above  described  gains; 
need  for  further  psychotherapy  after  she  moves. 

,  Ph.D. 


Chief  Psychologist 


The  orientation  of  the  staff  of  the  clinic  to  which 
Marie  resorted  for  help  was  rather  clearly  Freudian;  and 
we  may  conjecture  that  in  therapy  an  attempt  was  made 
to  get  her  to  feel  that  not  all  men  were  like  her  father 


Protestantism:  ii.  Challenge  and  Change        213 

md  that  she  therefore  had  no  justified  reason  to  fear 
them — and  sexual  relations.  But  if  we  assume,  as  we  rea- 
ionably  may,  that  Marie's  problem  was  not  simply  one  of 
traumatic  conditioning  against  sex  but  rather  an  incon- 
testable personal  guilt,  then  her  *'fear  of  men"  (as  author- 
ity figures)  was  justified,  in  a  very  different  way;  and  sens- 
ing that  the  therapy  was  not  addressed  precisely  to  her 
[leed,  it  is  perhaps  not  surprising  that  Marie  was  restive, 
dissatisfied,  and  eventually  "withdrew."  A  letter  from  the 
:herapist,  which  accompanied  the  materials  already 
presented,  is  particularly  illuminating.  It  reads,  in  part,  as 
Follows: 

I  am  happy  to  share  with  you  some  details  of  the  case  of 
a  young  womaiTwith  whom  I  worked  and  for  whom  the 
membership  in  the  Mormon  Church  seemed  to  be  a  con- 
structive change.  .  .  .  This  young  woman  had  been  a  mem- 
ber of  a  fundamentalist  Protestant  church,  in  which  she  ap- 
parently frequently  felt  terribly  guilty  when  she  was  present 
at  their  services.  I  have  the  feeling  that  therapy  may  have 
helped  her  to  reduce  enough  of  the  neurotic  guilt  so  that 
she  was  able  to  seek  out  a  religion,  which  was  guilt  reducing, 
paternalistic  and  supportive,  the  Mormon  religion.  Then 
perhaps  the  Mormon  religion  in  turn  is  helping  her  to  reduce 
the  neurotic  guilt  and  thus  handle  normal  guilt,  and  life  in 
general,  more  constructively. 

It  is  not  clear  why  reference  is  made  here  to  "neurotic" 
^uilt.  Surely  the  assumption  is  not  that  this  young  woman 
should  have  emerged  from  her  situation  with  no  guilt, 
or  that  the  guilt  she  felt  was  unjustified  or  dispropor- 
tionate. The  circumstances  were,  to  be  sure,  somewhat 
Extenuating;  and  it  is  much  to  the  girl's  credit  that  she 
Eventually  took  it  upon  herself  to  do  what  she  could  to 
rectify  matters.  But  it  is  hard  to  see  how  anyone  with 
Even  a  semblance  of  character  and  social  awareness  could 
have  gone  through  what  this  girl  had  and  be  more  normal 
or  symptom-free.  Here,  if  it  was  ever  the  case,  guilt  was 
a  facty  a  tragic  and  inescapable  reality,  and  not  just  a 
"neurotic"  feeling.  And  it  is  no  accident,  surely,  that 
secular  therapy  was  characterized  by  the  girl's  "wanting 
to  terminate  treatment  many  times,  and  finding  excuses 
for  not  coming  to  the  interviews."  We  can  hardly  escape 
the  inference  that  she  sensed  her  problem  was  not 
understood  and  that  no  real  help  would  be  forthcoming. 


214  The  Crisis  in  Psychiatry  and  Religion 

Here  we  also  have  an  excellent  example  of  the  com- 
mon failure  of  Protestant  churches  to  cope  with  desperate 
personal  guilt  on  the  part  of  its  members.  There  is  no 
indication  that  this  girl  went  to  her  minister  about  her 
problem  at  all;  and  if  she  had,  the  chances  are  he  would 
either  have  been  horrified  and  made  a  quite  nonfunc- 
tional scene  of  some  sort  or,  if  more  considerate,  would 
have  immediately  admonished  the  girl  to  ''seek  God's 
forgiveness  in  prayer."  If,  on  the  other  hand,  the  church 
had  been  liberal  (rather  than  Fundamentalist),  the 
minister  might  have  tried  to  be  more  enlightened  and 
to  "counsel"  with  her  along  essentially  secular  lines, 
with  a  reaction  similar  to  the  one  she  gave  to  the  therapy 
she  received  at  the  clinic. 

The  moral  of  this  case  is,  therefore,  clear:  it  indicates 
that  neither  Protestant  theology  nor  Freudian  psychology 
is  at  all  adequate  to  the  needs  of  deeply  guilty  people 
and  that  we  must  instead  seek  and  utilize  the  healing 
power  of  human  community  and  good  deeds,  rather  than 
ignore  and  despise  them. 

VIII.  confession,  community,  and  character 

In  February,  1960,  I  spent  a  few  days  on  the  campus 
of  the  State  College  at  Corvallis,  Oregon,  and  while 
there  Professor  Lester  A.  Kirkendall  told  me  of  the  fol- 
lowing observation.  Professor  Kirkendall  has  done  a  great 
deal  of  counseling  with  college  students,  particularly 
with  young  men;  and  over  the  years  he  says  he  has  found 
a  striking  correlation  between  a  student's  general  social 
adjustment  and  the  degree  of  normality  in  his  sex  life. 
If  the  man  has  good  social  relations,  the  chances  are 
very  high  that  he  will  report  no  serious  conflict,  perver- 
sion, or  the  like  in  the  sexual  realm.  But  if  there  is 
seclusiveness  and  uneasiness  with  people,  there  is  likely 
to  be  some  anomaly  in  the  matter  of  sex. 

Intuitively  this  relationship  is  not  surprising,  but  it 
is  useful  to  look  at  it  somewhat  more  analytically.  If 
there  is  perversity  or  evil  in  a  man's  sexual  practices,  it 
stands  to  reason  that  he  should  be  socially  ill  at  ease: 
if  he  has  any  character  at  all,  he  will,  as  a  matter  of 
course,  feel  guilty  and  will  be  uncomfortable  in  the 
presence  of  others.  But  this  perception  of  the  situation, 


Protestantism:  ii.  Challenge  and  Change        215 

valid  as  it  probably  is,  leaves  unanswered  the  question 
of  why  some  young  men  are  sexually  normal,  others 
perverse  and  deviant.  Dr.  Kirkendall  is  inclined  to  believe, 
and  I  certainly  share  his  impression,  that  good  control 
in  the  matter  of  sex  is  most  likely  to  be  achieved  in  an 
individual  who,  as  a  matter  of  policy  and  habit,  is 
socially  open,  has  a  strong  sense  of  community,  and 
shuns  secrecy  and  duplicity. 

We  are  likely  to  think  of  strength  of  character  and 
so-called  will  power  as  something  we  have  or  exercise 
deep  down  inside  us.  And  we  are  likely  to  try  to  improve 
this  capacity  in  others  by  admonishing,  scolding,  lectur- 
ing them.  I  am  increasingly  persuaded  that  will  power 
or  self-control  is  not  nearly  so  much  of  an  individual 
matter  as  we  sometimes  think.  Instead,  is  it  not  basically 
a  social  phenomenon?  Here,  in  society,  is  where  the 
norms  and  values  reside,  and  the  person  whose  life  is 
open  to  social  interaction  and  influence  has  the  benefit 
of  social  supports  and  sanctions.  But  the  individual  who 
embarks  upon  a  policy  of  covertness  and  secrecy  does  not 
have  this  source  of  strength  and  soon  finds  himself  the 
victim  of  uncontrollable  temptation  and,  as  he  is  likely 
to  experience  it,  a  "weak  will."  Superficially,  the  diffi- 
culty lies  in  the  area  of  his  sexual  drives  and  practices; 
but  more  fundamentally  the  problem  is  one  of .  social 
integration  or  the  lack  of  it. 

The  pertinence  of  confession  and  community  here  is 
obvious.  A  few  years  ago  I  was  discussing  this  general 
problem  in  a  summer-school  class,  and  a  student  spoke 
up  and  said  that  some  of  the  banks  in  Chicago  regularly 
give  their  employees  lie  detection  tests.  Not  immediately 
seeing  the  point  of  this  comment,  I  must  have  looked 
a  trifle  puzzled,  so  the  student  added:  "It  helps  them 
stay  honest."  I  then  realized  that  the  purpose  of  this 
procedure  is  not  so  much  to  detect  anyone  who  has 
already  done  something  wrong;  rather  it  is  to  create  a 
feeling  that  if  anyone  begins  a  dishonest  practice,  it  will 
soon  be  known.  This  amounts,  in  effect,  to  periodic 
"confession."  And  if  one  knows  that  whatever  he  does 
is  going  to  be  known,  one  usually  finds  that  he  has  the 
"will  power"  not  to  do  it.  Often  we  think  of  confession 
solely  as  a  mechanism  for  relieving  us  of  guilt  associated 
with  acts  already  committed.  If  confession  is  not  made 


216  The  Crisis  in  Psychiatry  and  Religion 

artificially  easy,  I  am  persuaded  it  has  not  only  this 
redemptive  function  but  also  a  strongly  prophylactic  one 
as  well. 

Sin,  as  Bonhoeffer  aptly  observes,  demands  to  have 
a  man  alone.  As  long  as  as  a  man  is  in  community,  in 
free  and  open  touch  with  others,  he  will  have  a  vivid 
sense  of  the  consequences  of  wrong  acts  which  gives  him 
the  strength,  and  wisdom,  not  to  commit  them — or,  if 
he  does,  to  move  rapidly  toward  their  rectification.  But 
if  he  has  committed  himself  to  the  path  of  hypocrisy,  of 
being  with  people  but  not  of  them,  he  does  not  have 
this  advantage  and  is  almost  certain  to  get  into  moral 
predicaments  of  one  kind  or  another. 

The  great  Protestant  emphasis  has  been,  of  course, 
not  upon  the  relation  of  man  to  man  but  on  the  relation 
of  man  to  God.  By-pass  human  intermediaries  and  take 
our  sins  and  concerns  directly  to  God  in  prayer,  that  has 
been  the  sovereign  Protestant  strategy.  For  the  morally 
and  religiously  well-developed  person,  I  am  sure  this  is 
often  sufficient.  The  man  of  character  so  prizes  a  clear 
conscience  and  free  communion  with  that  immanent  or 
transcendent  something  called  God  that  he  is  extremely 
careful  of  his  conduct,  without  any  necessary  reference 
to  whether  it  will  or  will  not  be  known  to  others.  But 
this  is  the  end,  not  the  means,  of  a  long  developmental 
process.  In  children  openness  and  integrity  have  to  be 
taught  and  experienced  first  in  the  context  of  the  family; 
and  when,  in  an  adult,  there  is  an  inadequacy  or  failure 
of  character,  personal  reconstruction  seems  far  more 
likely  to  occur  in  the  horizontal  than  in  the  purely 
vertical  dimension. 

What  is  the  place  of  ordinary  church  attendance  and 
public  worship  in  the  lives  of  men  and  women?  Again, 
for  the  religiously  and  morally  mature  and  the  emo- 
tionally healthy,  I  have  no  doubt  that  corporate  confes- 
sion is  helpful  and  ordinarily  sufficient.  But  in  extraor- 
dinary circumstances,  it  is  often  seriously  inadequate 
and  urgently  needs  to  be  supplemented  by  procedures 
which  are  generally  lacking  in  the  typical  Protestant 
church. 

One  of  the  great  problems  of  our  time  is  said  to  be 
that  the  average  man  doesn't  "know  who  he  is."  This 
is  a  sign  of  neuroticism.  Feelings  of  depersonalization  and 


Protestantism:  ii.  Challenge  and  Change        217 

a  sense  of  unreality  are  typical  of  the  experience  of 
severely  disturbed  persons.  How  else  would  we  expect 
it  to  be?  If  our  thesis  be  correct,  the  essence  of  psycho- 
pathology  is  systematic  denial  of  who  one  is;  and  if  we 
misrepresent  ourselves  to  others,  it  is  not  surprising  that 
we  soon  begin  to  appear  alien,  strange,  and  ''unfamiliar" 
even  to  ourselves.  Francis  Thompson  ends  the  first  stanza 
of  his  great  religious  poem  The  Hound  of  Heaven  with 
the  trenchant  thought,  "All  things  betray  thee  who 
betrayest  me."  We  cannot,  it  seems,  escape  the  fact  that 
we  can  be  true  to  ourselves  only  if  we  are  first  true  to 
others.  At  a  very  profound  level,  Shakespeare  was  right, 
of  course,  when  he  said  that  if  we  are  true  to  ourselves 
we  cannot  be  false  to  any  man.  That  is  to  say,  one's 
own  long-term  self-interest  is  consistent  with  his  social 
interest.  But  in  ordinary  day-to-day  practice,  we  are 
undoubtedly  on  sounder  ground  if  we  seek  to  find  our- 
selves in  the  life  of  the  group  than  if  we  attempt  to 
fashion  the  group  according  to  our  own  image  and 
designs. 

IX.    CONCLUDING   COMMENTS 
AND   RECOMMENDATIONS 

Increasingly  it  appears  that  the  central  fact  in  per- 
sonality disorder  is  real  guilt  and  that  it  can  be  radically 
resolved  only  by  confession  that  has  at  least  a  quasi-public 
character.  But,  as  we  have  seen  [cf.  Chapters  4,  5,  8, 
and  13],  this  always  involves,  at  least  in  well  developed 
personalities,  the  danger  of  a  catastrophic  reaction,  which 
may  take  the  form  of  psychosis,  suicide,  or  other  forms 
of  ''acting-out."  Assurance  of  God's  love,  grace,  and 
forgiveness  are  to  no  avail  in  such  a  crisis.  What,  then, 
should  clergymen  do  in  the  face  of  an  eventuality  of  this 
kind?  Here  I  have  only  tentative  suggestions  to  offer; 
but  I  am  convinced  that  sound  and  effective  measures 
can  and  will  be  found  if  religious  leaders  and  dedicated 
laymen  take  seriously  the  moral  basis  of  personality  dis- 
turbance and  allow  themselves  to  feel  the  full  force  of 
the  responsibility  which  thus  logically  devolves  upon 
them.  My  suggestions,  listed  more  or  less  randomly,  are 
these: 

1.  Clergymen  and  pastoral  counselors  need  to  have  at 


218  The  Crisis  in  Psychiatry  and  Religion 

their  disposal  facilities  for  providing  continuous  care  and 
supervision  for  persons  during  periods  of  acute  disturb- 
ance. If  the  acute  stages  of  a  personality  crisis  can  be 
handled  in  this  way,  more  protracted  institutionalization 
can,  I  believe,  often  be  avoided.  I  know  a  church  in 
Philadelphia  which  is  in  the  process  of  establishing  such 
a  facility,  to  be  staffed,  as  occasion  requires,  by  regular 
church  members,  its  ministers,  and  Christian  physicians. 

2.  A  special  effort  should  be  made  to  elicit  the  interest 
and  assistance  of  persons  who  have  themselves  had  per- 
sonality disturbances  and  have  made  a  good  recovery 
therefrom.  They  are  likely  to  have  less  fear  of  other 
disturbed  individuals  than  does  the  ordinary  person;  and 
they  often  also  have  deep  insights  and  are  highly  mo- 
tivated. Care  of  and  concern  for  others  is  powerfully 
therapeutic  in  its  own  right. 

3.  Ministers  need  to  band  together  in  their  community 
for  a  sort  of  "group  practice."  In  this  way  the  individual 
counselor  can  be  made  both  more  cautious  and  more 
courageous,  with  group  consultation  and  supervision 
available  to  him.  A  project  in  Kokomo,  Indiana,  which 
has  been  inaugurated  by  Granger  Westberg,  with  sup- 
port from  the  Lilly  Endowment,  offers  a  model  for  this 
type  of  development. 

4.  Ministers  with  specialized  training  and  experience 
in  counseling  can  be  of  great  assistance  in  guiding, 
teaching,  and  supporting  other  ministers  in  their  efforts 
in  this  area.  Russell  Dicks  has  recently  established  him- 
self, in  a  community  in  Florida,  in  a  unique  kind  of 
"private  practice."  His  plan  is  to  accept  referrals  from 
other  ministers  and  to  deal  with  them,  on  a  fee  basis, 
while  at  the  same  time  encouraging  the  ministers  making 
the  referrals  to  follow  developments  and  thereby  extend 
and  improve  their  own  competence.  Such  a  procedure, 
if  widely  adopted,  is  almost  certain  to  evoke  a  protest 
from  the  psychiatric  profession  (see  Joint  Committee 
on  Relations  between  Psychology  and  Psychiatry,  1960). 
But  if  its  effectiveness  can  be  demonstrated,  social  and 
legal  protection  will  follow. 

5.  Young  Protestant  clergymen  with  whom  I  have 
recently  talked  complain  of  their  "lack  of  authority"  in 
dealing  with  problem  persons.  They  lack,  they  say,  the 
sanctions  of  both  priest  and  physician  and  feel  quite 


Protestantism:  ii.  Challenge  and  Change        219 

helpless  in  asserting  any  kind  of  decisive  influence  upon 
others  in  time  of  crisis.  My  conviction  is  that  as  their 
competence  and  confidence  in  this  area  grow,  ministers 
will  find  that  so  also  have  "authority."  Clinical  psychol- 
ogists, in  a  somewhat  similar  predicament,  have  found 
that  making  continued  psychotherapeutic  contact  con- 
tingent is  often  effective  in  inducing  client  compliance. 

6.  The  individual  undergoing  acute  personal  crisis 
needs  to  see  the  potentially  constructive,  growth-inducing 
potentialities  of  the  experience.  Here  the  writings  of 
Anton  T.  Boisen  can  be  particularly  helpful.  I  believe 
in  encouraging  the  disturbed  person  to  see  his  situation 
as  involving  what  Old  Testament  writers  referred  to  as 
the  Wrath  of  God.  At  the  same  time  it  should  be  pointed 
out  that  the  Wrath  of  God  is  the  form  in  which  those 
who  defy  Hirn  experience  His  Love.  The  chastisement 
of  an  unruly  child  by  loving  parents  is  a  meaningful 
analogy. 

7.  While  accepting  the  self-condemning  and  self-pun- 
ishing tendencies  of  the  "sick"  individual  as  under- 
standable, reasonable,  and  even  right  in  a  certain  sense, 
an  effort  should  be  made  to  help  him  move  as  rapidly 
as  possible  from  expiation  to  restitution,  from  self-lacera- 
tion to  a  program  of  service,  self-discipline,  and  meaning- 
ful sacrifice.  In  my  judgment  the  reason  electroshock 
convulsions  are  often  "therapeutic"  (especially  in  depres- 
sions) is  that  they  aid  and  expedite  the  work  of  self- 
punishment.  In  the  preceding  lecture  we  have  alluded 
to  the  extent  to  which  charity  has  become  secularized 
and,  in  a  sense,  even  commercialized  (as  "insurance"  of 
various  kinds).  In  Zborowski  and  Herzog's  recent  book. 
Life  Is  with  People,  an  interesting  picture  is  given  of 
traditional  Jewish  life  in  the  now  all  but  vanished  "stetl" 
villages  of  Eastern  Europe.  There  philanthropy  was  con- 
tinuously practiced,  by  almost  everybody,  as  an  everyday 
aspect  of  ongoing  social  and  religious  life.  Many  of  the 
traditional  occasions  for  generosity  have,  of  course,  dis- 
appeared in  modern  society;  but  there  are  always  impor- 
tant and  deserving  "causes"  to  which  one  can  contribute 
time  and  money.  It  is  thus  not  so  much  the  opportunity 
for  generosity  which  has  disappeared  as  the  logical  and 
psychological  rationale  therefor.  The  latter  desperately 
needs  to  be  recovered. 


220  The  Crisis  in  Psychiatry  and  Religion 

8.  The  Apostle  Paul  has  warned  against  attempted 
"justification"  through  good  works,  "lest  any  man  should 
boast."  Then  let  us  not  "boast"  but  rather  make  restitu- 
tion and  perform  good  deeds  without  publicity  and  self- 
acclaim.  Attempts  to  pray,  analyze,  or  tranquilize  our- 
selves out  of  sin  have  been  ineffective.  A  more  active 
form  of  "therapy"  seems  our  only  remaining  option. 

Somewhat  parenthetically  I  want  to  say  that  I  am  not 
unaware  that  the  approach  here  proposed  is  at  least  super- 
ficially paradoxical:  it  might  be  characterized  as  a  sort 
of  irreligious  religious  approach  to  the  problem  of  per- 
sonality disturbance.  More  accurately,  one  might  say 
that  the  approach  is  actively  religious  but  minimally 
theological  in  the  conventional  sense  of  that  term.  The 
approach  is  religious  in  the  sense  that  it  accepts  the 
reality  of  unconfessed  and  unredeemed  sin  as  central  in 
psychopathology  and  holds  confession  and  restitution  to 
be  commonly  necessary  for  recovery.  But  it  involves  a 
minimal  theological  emphasis  in  that  it  stresses  the 
interpersonal  dimension  as  more  crucial  for  therapeutic 
movement  than  the  man-God  relationship  because  it  is 
the  former  that  has  been  most  palpably  ruptured  and  can 
be  repaired,  in  many  instances,  only  by  the  individual's 
working  hard  at  modifying  and  improving  his  everyday 
conduct. 

Some  years  ago  I  heard  a  Park  Avenue  minister,  in 
New  York,  take  the  position  that  if  man's  relation  with 
God  goes  wrong,  he  is  soon  in  trouble  with  his  fellow 
men,  and  that  when  this  happens  he  is  automatically  in 
trouble  with  himself;  so,  by  implication,  the  place  to 
start  "therapy"  or  redemption  is  in  the  vertical,  man- 
God  dimension.  Empirically,  this  assumption  does  not 
seem  to  be  well  borne  out.  And  the  psychoanalytic  as- 
sumption that  we  have  to  work  on  our  relationship  with 
ourselves  has  also  been  a  disappointment.  The  possibility 
that  remains  is  the  interpersonal  approach,  and  it  is  the 
one  which  is  now  attracting  most  interest  from  secular 
students  of  the  problem.  It  is  also  the  one  which  holds 
greatest  promise  of  a  genuine  rapprochement  between 
science  and  religion  in  this  area.  Dr.  Gordon  McKay, 
President  of  McCormick  Theological  Seminary,  has  a 
talk  which  he  sometimes  gives  to  ministers  entitled, 
"Don't  Pray  Too  Soon."  I  have  not  personally  heard  this 


Protestantism:  ii.  Challenge  and  Change        221 

talk,  but  Dr.  McKay  has  recently  written  concerning  it 
as  follows: 

The  general  notion  behind  the  talk  is  that  prayer  is  too 
frequently  employed  as  a  substitute  for  action.  Beyond  that^ 
the  resort  to  prayer  is  frequently  among  ministers  little  more 
than  a  cover-up  for  their  ignorance  and/or  unwillingness  to 
employ  such  community  recourses  as  are  available  to  serve 
the  needs  of  men  and  women  whose  lives  are  blighted  by 
such  problems  as  alcoholism,  marital  discord,  and  mental 
illness. 

It  seems  to  me  that  a  full  understanding  of  the  Pauline 
concept  of  salvation  requires  us  to  recall  that  Paul's  strong 
insistence  on  justification  by  faith  was  always  coupled  with 
the  admonition  that  we  are  to  work  out  our  salvation  with 
fear  and  trembling.  Every  great  theological  discourse  in  Paul's 
writings  is  followed  by  a  chapter  or  two  on  moral  teaching. 

And  recently  I  heard  Dr.  Roy  Burkhart,  of  the  First 
Community  Church  in  Columbus,  Ohio,  say  that  salva- 
tion is  a  social  operation.  Certainly  there  is  a  growing 
disposition  on  the  part  of  sensitive  and  perceptive  clergy- 
men to  emphasize  this  approach.  It  is,  I  believe,  ex- 
tremely promising;  and  if  metaphysical  assumptions  can 
be,  at  least  for  the  time  being,  held  in  abeyance  and  a 
renewed  emphasis  put  upon  the  interpersonal  dimension, 
[  believe  something  of  a  "break-through"  can  be  achieved. 


13 

Footnotes  to  a  Theory 
of  Psychopathology"^ 

As  the  title  indicates,  this  chapter  repersents  an  attempt 
to  pick  up  loose  ends  of  fact  and  logic  and  tie  them  into 
the  general  argument  with  which  this  book  is  concerned. 
Here  we  see,  again,  the  internal  weaknesses  of  psycho- 
analysis, both  as  formal  structure  and  as  a^' system  of 
practice,  and  the  ambiguity  of  a  theology  which  finds  it 
congenial. 

Not  long  ago,  in  talking  with  a  Lutheran  minister, 
I  remarked  of  a  certain  church  practice  that  it  might  be 
theologically  necessary  and  sufficient  but  that  it  was 
manifestly  not  psychologically  adequate.  To  which  my 
friend  replied:  ''In  my  opinion,  if  a  practice  is  not  psy- 
chologically adequate,  it's  not  theologically  adequate!" 
Here,  surely,  is  a  fine  spirit,  which  can  go  far  toward 
forging  the  new,  unified  conception  of  man  in  which  we 
today  stand  in  such  need.  But  in  this  chapter  we  see, 
with  special  clarity,  that  before  a  valid  synthesis  of  this 
kind  can  come  about,  we  must  have  both  a  psychology 
and  a  theology  which  are  in  certain  important  respects 
different  from  what  we  have  recently  known.  In  other 
words,  our  explorations,  here  and  in  other  chapters  of 
this  book,  suggest  reform  in  contemporary  theology  as^ 
well  as  in  psychiatry  and  clinical  psychology. 


1 


In  a  series  of  recent  papers  [Chapters  2,  8,  and  9], 
I  have  dehneated  that  conception  of  personahty  dis- 
order which  seems  to  me  logically  most  compelling,  em- 
pirically best  supported,  and  therefore  most  promising 
in  terms  of  new  and  more  radically  effective  methods  of 
personal    (and   social)    reconstruction.   Here  it  will  be 

*  Presented  April  20,  1960,  before  the  Los  Angeles  Society  of 
Neurology  and  Psychiatry  and  independently  published  in 
Progress  in  Clinical  Psychology  (D.  Biower  &  L.  E.  Abt,  edi- 
tors), Grune  &  Stratton,  1960. 

222  i 


\  Theory  of  Psychopathology  223 

leither  possible  nor  necessary  to  restate  that  conception 
n  any  comprehensive  way.  Instead,  the  present  paper 
vill  take  for  granted  a  general  familiarity  with  this 
:heoretical  framework  and  will  advance  some  additional 
considerations  in  the  nature  of  footnotes  or  marginal 
ottings  and  comment. 


:.   CHANGING   PERSPECTIVES 

Viewed  in  retrospect,  how  truly  remarkable  was  that 
conception  of  psychopathology  which  dominated  theory 
md  practice  two  or  three  decades  ago!  Genuine  guilt, 
ustified  self-loathing,  and  realistic  interpersonal  uneasi- 
less  were  given  little  or  no  weight  in  the  genesis  of  the 
o-called  psychoneuroses,  where  false  conscientiousness 
vas  assumed  to  be  capable  of  playing  veritable  havoc, 
n  other  words,  a  supposedly  overly  severe  superego, 
temming  from  unduly  strict  childhood  training  and 
otally  unsupported  by  ongoing  experience  and  social 
)r  legal  realities,  was  assumed  to  be  more  powerful  and 
herefore  more  likely  to  disturb  or  destroy  our  peace  of 
nind  than  was  a  sound,  realistic,  normal  conscience 
vhich  the  individual  had  outraged  by  engaging  in  palpa- 
)le,  unacknowledged,  and  unredeemed  misconduct.  Such 
I  thesis  is  clearly  contrary  to  common  sense  and  what  we 
enow  about  the  principles  of  reinforcement  and  extinc- 
:ion  (in  learning  theory)  and  is  controverted  by  all  sorts 
)f  clinical  evidence;  yet  it  was  seized  upon  and  pro- 
laimed  as  a  great  scientific  discovery  and  cultural  achieve- 
nent. 

Now,  within  the  last  five  or  ten  years,  the  picture 
las  changed  considerably.  No  longer  is  it  maintained 
:hat  the  Freudian  doctrine  is  universally  applicable  but 
)nly,  perhaps,  in  some  cases.  For  example,  Jourard 
[1958)  interprets  the  present  situation  as  follows: 

Clinical  experience  suggests  that  neither  Freud  nor  Mowrer 
is  wholly  correct  or  wholly  incorrect.  Rather,  it  can  be  found 
that  some  neurotic  patients  do  indeed  have  a  conscience 
that  is  too  strict;  in  order  to  remain  guilt-free,  they  must 
refrain  from  all  pleasurable  activities,  including  those  which 
society  condones.  Other  patients  may  be  found  with  the 
makeup  which  Mowrer  has  regarded  as  nuclear  to  all  neurosis 


224  The  Crisis  in  Psychiatry  and  Religion 

— they  repress  conscience  so  they  can  break  social  taboos 
without  conscious  guilt  (p.  366). 

This  is  not  necessarily  an  illogical  position,  but  there 
is  reason  to  doubt  its  factual  validity.  If,  a  generation 
ago,  psychoanalysts  were  unable  to  recognize  the  presence 
and  operation  of  real  guilt  in  persons  fairly  devastated 
by  it  and  so  treated  everyone  as  if  they  suffered  only  from 
false  guilt,  why  should  we  now  trust  them  to  make 
exactly  the  right  distinction  between  the  two  classes  of 
'"neurotics"  which  Jourard  and  many  others  are  today 
suggesting?  Diametrically  opposed  types  of  "therapy" 
would  presumably  be  called  for  in  the  two  different  sit- 
uations; and  it  is  of  some  importance,  obviously,  that  the 
^'differential  diagnosis"  be  made  with  precision  and  dis- 
cernment. In  the  one  instance,  the  goal  of  therapy  pre- 
sumably remains  that  of  reducing  the  severity  of  the 
superego,  i.e.,  attempting  to  close  the  painful  discrepancy 
between  a  person's  moral  aspirations  and  his  perform- 
ance by  lowering  the  level  of  the  moral  aspirations; 
whereas,  in  the  other  situation,  the  therapeutic  objective 
is  that  of  helping  the  patient  become  a  better  person, 
i.e.,  to  improve  and  raise  the  level  of  his  performance. 

When  did  psychoanalysts  or,  for  that  matter,  secular 
therapists  in  general,  acquire  special  skill  and  competence 
along  these  latter  lines?  Their  formal  professional  train- 
ing and  theoretical  orientation  has  been  almost  exclu- 
sively in  the  reverse  direction.  When  did  they  sud- 
denly discover,  if  they  have,  that  they  are  also  uniquely 
equipped  to  work  with  this  other  type  of  personality 
disturbance?  Even  if  the  secular  therapist  were  wise 
enough  to  be  able  to  tell  in  advance  of  treatment  ("diag- 
nostically")  whether  a  given  person  falls  into  the  one 
category  or  the  other,  and  even  though  he  admitted  he 
had  no  special  competence  in  dealing  with  the  individual 
suffering  from  real  guilt,  there  is  still  an  interesting  ques- 
tion as  to  what  he  would  then  do  with  such  persons. 
When  the  secular  therapist  today  discovers  that  a  patient 
is  suffering  from  a  genuine  moral  dilemma  or  ambiguity, 
rather  than  an  imaginary  ("neurotic")  one,  what  does 
he  typically  do — meticulously  "refer"  such  a  person  to 
pastoral  counselors?  Are  secular  therapists,  who  in  the 
past  were  so  insistent  that  parish  ministers  and  chaplains 


.  Theory  of  Psychopathology  225 

jcognize  their  "limitations"  and  know  when  to  "refer," 
ow  recognizing  their  own  hmitations  and  making  coun- 
;r-referrals?  Or  is  the  flow,  for  economic  reasons,  still 
irgely  in  the  one  direction? 

We  cannot  here  hope  to  settle  the  question  as  to 
hether  there  is  indeed  a  residual  class  of  persons  who, 
Freud  insisted,  suffer  from  over-conscientiousness, 
ither  than  justified  and  realistic  pangs  of  conscience.^ 

^A  somewhat  different  way  of  approaching  this  problem  has 

;en  suggested  by  Dr.  H.  J.  Eysenck  in  his  book,  The  Dyna- 

ics  of  Anxiety  and  Hysteria:   "In   closing   this   chapter   [on 

acialization  and  Personality]  we  may  fittingly  return  to  the 

ifference  in  opinion  we  noted  in  our  second  chapter  between 

lowrer  on  the  one  hand  and  Dollard  &  Miller  [1950]  on  the 

fcher.  It  will  be  remembered  that  in  their  theories  of  neurosis 

lese  writers  were  in  sharp  contradiction,  Mowrer  advocating 

theory  according  to  which  the  Id  was  too  powerful  as  opposed 

i)  the  Super-Ego,  while  Dollard  &  Miller  [with  Freud]  advo- 

ated   a   theory   according   to   which   the   Super-Ego   was   too 

erful  as  opposed  to  the  Id.  We  can  now  see  that  these 

heories  are  relevant,  not  to  neurosis,  but  to  extroversion-intro- 

ersion.  What  we  have  called  excessive  degree  of  socialization, 

ue   to   strong   conditionability,   these   writers   call   Super-Ego; 

/hat  we  have  called  insufficient  degree  of  socialization,  due  to 

;eak  conditionability,   these  writers  call   Id.   Mowrer  appears 

0  be  dealing  exclusively  with  the  extroverted  symptoms  and 

yndromes,  Dollard  &  Miller  with   the  introverted   symptoms 

nd  syndromes.  If  there  is  any  truth  in  our  theory,  then  it  will 

te  clear  that  both  sides  fail  to  come  to  grips  with  the  problem 

if  neurosis,   or  excessive  emotionality,   i.e.,   that  which   is   in 

ommon   to  both   hysterics  and   dysthymics,   and   deal   rather 

yith  a  continuum  which  is  orthogonal  to  neuroticism.  Thus 

lur  theory  appears  to  reconcile  the  apparently   contradictory 

observations  of  these  men  in  a  larger  synthesis.  It  also  succeeds 

n  getting  away  from  the  reification  inevitable  in  the  use  of 

uch  concepts  as  Id  and  Super-Ego,  and  it  provides  a  mecha- 

lism   causally  responsible   for   individual   differences   in   these 

espects  which  has  a  solid  experimental  foundation  and  whose 

aws  of  functioning  are  reasonably  well  known.  For  all  these 

easons  we  venture  to  offer  this  theory  as  not  only  an  alterna- 

ive  to,  but  as  an  improvement  on,  those  of  Mowrer,  and 

Dollard  &  Miller"    (pp.  221-222).  Like  Jourard,  Eysenck  is 

lere  suggesting  that  there  may  be  psychopathology  on  "both 

;ides"  of  what  he  calls  the  extroversion-introversion  scale,  taking 

ihe  form  of  hysteria  in  the  one  case,  anxiety  (dysthymia)  in  the 

3ther.  Normality  and  abnormality  then  depend  upon  another 


226  The  Crisis  in  Psychiatry  and  RELIGIO^ 

But  it  will  be  useful  to  examine  a  few  of  the  circum- 
stances which  do,  to  be  sure,  often  give  a  superficial 
impression  of  justification  for  the  Freudian  perception 
of  the  situation.  Typically,  when  adult  human  beings 
present  themselves  for  therapy,  they  are  inhibited,  de- 
pressed, anxious,  conscience-stricken.  But  this,  manifestly, 
is  not  their  "normal"  state  of  mind  and  being,  to  which 
they  long  to  return.  Quite  regularly,  when  we  get  into 
the  situation,  we  discover  that  a  little  while  back  these 
persons  have  been  something  very  far  from  inhibited, 
repressed,  unexpressive.  A  psychoanalytic  friend  of  mine 
used  to  be  fond  of  saying:  ''There  is  just  one  thing  wrong 
with  the  people  who  walk  through  the  door  of  my  office: 
they  haven't  been  having  any  funJ'  They  were,  to  be 
sure,  at  the  moment  too  depressed  and  too  anxious  to 
enjoy  life.  But  when  we  go  into  the  question  of  how 
they  got  that  way,  information  is  usually  forthcoming 
which  clearly  suggests  a  very  different  interpretation  ol 
the  situation. 

But  what  of  the  person  who  is  more  or  less  chronically 
over-conscientious:  the  so-called  obsessive-compulsive  oi 
the  victim  of  religious  scrupulosity?  These  are  certainly 
driven,  tortured  people;  what  is  their  underlying  "dyna- 
mics"? We  can,  of  course,  assume  that  Lady  Macbeth 
had  a  hand-washing  compulsion  because  her  mother  (oi 
nurse)  was  too  zealous  in  "cleanliness  training"  and  thus 
gave  to  My  Lady  spuriously  high  standards  in  these  mat- 
ters. Or  we  can  assume,  as  Shakespeare  obviously  did, 
that  the  excessive  preoccupation  with  "hand-washing" 

variable,  termed  "excessive  emotionality,"  which  is  independeni 
of  (orthogonal  to)  the  first  dimension.  All  of  which,  it  seems, 
tends  to  beg  the  question:  What  determines  the  proneness  tc 
this  excessive  emotionality?  Dr.  Eysenck  has,  I  believe,  toe 
quickly  and  for  logically  insufficient  reasons  dismissed  the 
matter  of  id-ego-superego  balance  as  irrelevant  to  the  probleir 
of  neuroticism.  And  informal  reports  from  his  laboratory  indr 
cate  that  the  empirical  justification  for  his  attempted  re-^inter- 
pretation  may  not  be  as  substantial  as  it  appeared  to  be  (in 
1957)  when  The  Dynamics  of  Anxiety  and  Hysteria  was  pub- 
lished. But  it  is,  of  course,  very  much  to  the  good  that  Dr. 
Eysenck  and  his  co-workers  have  been  willing  to  attack  this 
problem  in  terms  of  evidence  other  than  that  provided  by  mere 
clinical  observation  and  impression. 


. 


Theory  of  Psychopathology  227 


/as  energized  by  a  displaced  guilt  which,  in  its  own  right, 
i'as  only  too  terribly  real.  In  the  case  of  the  Catholic 
mo  must  confess  and  confess,  without  deriving  any 
elief  therefrom,  may  we  not  also  reasonably  suspect 
with  Stafford,  1950)  that  this  compulsion  continues 
irecisely  because  the  individual  is  careful  to  see  that 
lis  "confession"  never  goes  all  the  way,  never  really  gets 
the  heart  of  the  matter?  It  is,  of  course,  not  at  all 
lifEcult  to  find  instances  of  displaced — and  therefore 
eemingly  unrealistic,  unjustified — guilt.  We  must  be 
areful  not  to  accept  a  superficial  perception  of  the 
situation  as  basic  and  ultimate. 

In  light  of  considerations  such  as  those  just  advanced, 
ome  may  ask:  But  is  it  not  possible  that  the  picture  has 
hanged?  Perhaps  it  is  true  that  the  majority  of  clinical 
)roblems  today  involve  real  moral  inadequacy  or  fail- 
ire;  but  during  the  so-called  Victorian  era,  in  which 
"•reud  made  his  original  observations  and  formulated  his 
heories,  may  not  the  picture  have  been  typically  other- 
vise?  We  cannot,  of  course,  say  categorically  that  such 
m  interpretation  is  untrue,  but  it  is  improbable.  Freud, 
ve  must  recall,  lived  and  worked  in  Vienna,  which  was 
lever  exactly  famous  for  its  prudery  or  restraint  in  sexual 
natters.  Besides,  as  Progroff  (1956)  has,  recently  pointed 
)ut,  Adler,  Jung,  and  Rank  (also  Stekel  and  many 
Dthers)  broke  with  Freud,  not  on  personal  grounds,  but 
because  they  could  not  find  in  the  clinical  data  justifica- 
:ion  for  the  inferences  which  Freud  boldly  drew.  The 
lata  to  which  these  men  had  access  were  essentially  the 
jame  as  Freud's,  yet  they  could  not  agree  with  him,  even 
:hen  (see  also  Ichheiser,  1960). 

There  can,  of  course,  be  little  question  that  sexual 
norality  was  somewhat  stricter  and  probably  better  ob- 
;erved  60  or  70  years  ago  than  it  is  today.  But  the 
question  is:  Was  it  excessively  high  then  or  is  it  danger- 
ously low  now?  Many  astute  observers  of  the  contem- 
porary scene  (LaPiere,  1959;  Fitch,  1960)  are  suggesting 
that  the  latter  assumption  comes  closer  to  the  truth  of 
the  matter. 

It  is,  of  course,  clear  that  man  is  more  susceptible  to 
self-condemnation  and  therefore  "neurosis"  (if  he  han- 
dles his  guilt  badly)  when  he  holds  high  standards  for 
iiimself  than  when  his  standards  are  low  or  nonexistent. 


228  The  Crisis  in  Psychiatry  and  Religioi« 

And  as  I  have  suggested  on  another  occasion  [Chaptei 
9],  Freud's  "mission,"  as  he  conceived  it  (see  Fromm 
1959),  v^'as  to  introduce  a  new  era  of  "psychologica  il 
hberty"   (Bakan,  1958).  We  are  now  far  enough  intc 
this  "era"  to  have  both  a  retrospective  and  a  prospectiv 
view  of  it,  which  we  do  not  seem  to  like.  In  simples 
terms,  it  involves  a  level  of  morality  and  responsibility' 
comparable  to  that  of  beasts  in  a  jungle,  each  of  whicb 
"thinks"  essentially  of  himself  and  his  "natural"  needs! 
and  has  a  minimum  of  social  awareness.  j 

Recently  an  intelligent  woman  told  me  of  a  conver-i 
sation  she  once  had  with  an  analytically-oriented  child- 
guidance  expert.  She  said  one  of  her  teen-age  sons'  chores! 
around  the  house  was  that  of  emptying  the  waste  baskets. 
Sometimes  he  was  dilatory  or  refractory  about  doing  this. 
Now,  asked  the  mother,  "Should  we  require  him  to 
perform  this  task  or  should  we  let  him  do  as  he  likes 
about  the  matter?"  The  reply  was,  "But  why  should 
the  boy  have  to  do  this  if  he  doesn't  want  to.  He  didn't 
ask  to  be  born  into  your  family."  This  may  be  one  way 
to  avoid  inner  conflict  in  human  beings,  to  let  children 
grow  up  as  mere  "blobs"  (Robert  Fitch's  term!);  but 
socially  and,  in  the  long  run,  individually  (see  Link, 
1937),  it  is  surely  a  form  of  "treatment"  that  is  worse 
than  the  original  "disease." 

In  light  of  the  developments  which  have  been  alluded 
to  here,  present-day  apologists  for  psychoanalysis  and 
kindred  "therapies"  are  fond  of  saying:  "Yes,  to  be  sure, 
there  were  some  inadequacies  and  errors  in  Freud's  orig- 
inal formulations  and  prescriptions.  But  there  have  been 
great  advances  in  our  science  since  Freud's  time."  How- 
ever, on  close  inspection,  these  alleged  "advances"  turn 
out  to  be  more  nearly  in  the  nature  of  retreats.  One  of 
the  allegedly  great  new  developments  in  psychoanalysis 
is  the  shift  from  the  original  emphasis  upon  unconscious 
mechanisms  to  so-called  "ego  psychology,"  which  in- 
volves, essentially,  a  new  emphasis  upon  what  has  always 
been  known  as  ego  strength,  character,  or  "will  power." 
One  of  the  distinguishing  features  of  Freud's  doctrine 
was  its  emphasis  on  "The  Unconscious,"  and  now  this 
is  being  abandoned  in  favor  of  "ego  psychology,"  which 
analysts  are  frank  to  say  they  as  yet  know  very  little  about 
"because  it  is  so  new  to  us  and  we  are  only  beginning 


\  Theory  of  Psychopathology  229 

[0  investigate  it."  Common  sense  has  been  concerned 
A'ith  these  matters  for  a  very  long  time! 

The  most  seminal  and  indigenous  movement  in  Amer- 
can  psychiatry  during  this  century  has  unquestionably 
3een  the  emphasis  of  Harry  Stack  Sullivan  (following 
t.eads  suggested  by  Adolph  Meyer)  upon  the  interper- 
sonal nature  of  psychiatric  problems,  an  emphasis  which 
fias  been  echoed,  in  one  form  or  another  by  virtually  all 
of  the  so-called  neo-Freudians,  notably  including  Eric 
Fromm  and  Frieda  Fromm-Reichmann.  But  is  this  new? 
Throughout  history,  the  world  over,  it  has  been  assumed 
that  there  is  a  connection  between  "sin"  and  ''sickness," 
i.e.,  between  how  one  deals  with  others  and  what  happens 
to  oneself.  The  apostle  Paul  gave  this  principle  its  classi- 
cal Christian  formulation  when  he  proclaimed  that  the 
"wages  of  sin.  is  death,"  a  psychological  and  spiritual 
death  (as  opposed  to  the  abundant  life  which  comes 
from  the  reverse  of  evil);  but  the  principle  itself  is  a 
universal  one  and  by  no  means  exclusively  Christian .^ 

No,  the  modification  and  revisions  which  Freud's  fol- 
lowers are  having  to  make  in  their  theories  and  practice 
ire  not  extensions  in  the  direction  which  Freud  origi- 
nally took,  but  are  rather  "advances  to  the  rear."  They  are 

^  Since  the  above  was  written,  Dr.  Perry  London  and  I  have 
conducted  a  graduate  seminar  on  "The  Nature  and  Manage- 
ment of  Guilt,"  in  which  many  of  the  foregoing  issues  were 
considered.  In  response  thereto,  pro-Freudian  students  made 
the  following  points:  (1)  Psychoanalysis  is  still  a  "young 
science"  and  has  perhaps  not  yet  had  a  fair  chance  to  demon- 
strate what  it  can  do.  If  one  will  pursue  the  references  cited 
in  this  paper,  I  believe  he  will  come  to  question  the  grounds 
for  such  optimism  (if  one  can  call  it  that!).  And  (2),  a 
related  consideration:  Granted  that,  during  the  half  century 
or  so  that  psychoanalysis  has  been  with  us,  the  world  has  not 
greatly  improved,  may  this  not  be  due  to  other  factors — such 
as  urbanization  and  loss  of  primary-group  contacts,  the  auto- 
mobile and  television,  two  world  wars,  etc.?  In  other  words, 
why  blame  psychoanalysis  (the  "Freudian  Ethic")  for  all  our 
ills?  Historical  progression  (or  retrogression)  is,  of  course, 
always  complicated,  intricate,  multi-faceted;  and  there  is  surely 
no  disposition  on  the  part  of  anyone  to  hold  psychoanalysis 
exclusively  responsible  for  the  pervasive  "sickness"  of  our 
society.  But,  in  the  light  of  the  varied  evidence  now  available, 
let's  at  least  be  very  cautious  about  the  continued  assumption 
that  psychoanalysis  is  the  cure. 


230  The  Crisis  in  Psychiatry  and  Religion' 

reversals^   which   are  euphemistically — and   misleadingly 
— called  "progress." 

Ih   IF   ALL   B   IS   A,    IS   ALL   A,    B? 

OR    ''the   lord   IS    SLOW   TO   WRATH*' 

On  numerous  occasions,  a  supposedly  devastating  criti- 
cism has  been  leveled  against  the  hypothesis  that  there 
is  a  connection  between  moral  failure  and  psychopathol- 
ogy.  Phrased  in  various  ways,  its  basic  form  is  this:  If  all 
neurotic  and  functionally  psychotic  individuals  have  a 
history  of  unacknowledged  and  unredeemed  real  guilt, 
are  all  sinful,  guilty  persons  neurotic  or  psychotic?  Mani- 
festly the  latter  is  not  true,  and  the  stratagem  underlying 
this  question  involves  an  effort  to  discredit  the  whole 
emphasis  on  moral  considerations  in  mental  illness  by 
means  of  a  classical  non  sequitur.  Elsewhere  [Chapter  3] 
I  have  called  attention  in  this  connection  to  that  class 
of  persons  who  engage  in  thoroughly  evil,  antisocial 
behavior  but  who  simply  do  not  have  the  character — or, 
as  one  may  say,  the  "common  decency" — to  go  crazy. 
It  takes  a  fairly  adequate  personality  to  be  seriously 
""disturbed";  in  fact,  the  very  power  of  neurotic  and 
psychotic  affects  attests  to  their  strength  of  character. 

Also,  some  persons  have  the  good  sense  to  rectify 
personal  mistakes  shortly  after  they  occur  and  thus  do 
not  allow  themselves  to  fall  into  a  chronic  state  of  sin, 
disgrace,  "neurosis."  But  over  and  beyond  these  consid- 
erations [cf.  Chapter  10],  there  is  another  phenomenon 
about  which  I  should  like  to  speak  in  a  little  more  detail. 

Imagine,  if  you  will,  a  sort  of  "teeter-totter,"  such  as 
shown  in  Fig.  1.  A  child,  let  us  assume,  is  normally  born 
on  the  left  side.  He  does  not  at  first  have  to  proye" 
himself.  He  is  loved,  accepted,  "respected"  because  he  is 
our  baby — and  can,  at  first,  do  no  wrong.  But  then,  as 
the  months  and  years  pass,  we  begin  to  make  demands 
upon  him  to  "be  good."  Our  approval  is  no  longer  auto- 
matic, unconditional.  In  a  word,  the  child's  socialization 
begins.  Let  us  assume  that  all  goes  well  in  this  connec- 
tion and  that,  despite  occasional  mischief  or  naughtiness 
(i.e.,  light  forms  of  "sin"),  this  child  remains  basically 
good,  i.e.,  learns  how  to  earn  approval,  respect,  trust. 
We  say  the  child  is  developing  well  and  deserves  a  good 


A  Theory  of  Psychopathology  231 


-C:? 


Fig.   1.  Diagram  suggesting  how  a  gradual  impairment  of 

\;self -respect    {through  continued  wrong-doing)    may  lead  to  a 

sudden  emotional  ''imbalance"  or  ''breakdown."  Only  by  again 

getting  the  virtue  in  one's  life  to  outweigh  the  evil  can  the 

balance  be  righted"  and  "equilibrium"  restored. 

deal  of  "credit" — which  is  represented  by  the  "box" 
shown  on  the  left  end  of  the  teeter-totter  and  which  is 
experienced  subjectively  as  self-respect. 

The  years  pass.  This  child  becomes  an  adolescent  and 
[is  no  longer  under  close  parental  supervision  and  guid- 
ance. Now  he  (or  she)  begins  to  try  his  wings  a  bit,  to 
reality  test."  What  would  happen,  our  youth  wonders, 
if  he  tasted  the  "forbidden  fruit."  And  he  makes,  let  us 
say,  a  brief  excursion  out  on  the  wrong  or  "evil"  end  of 
the  teeter-totter  and  then  retreats  again  to  the  good  end. 
Our  young  adventurer  may  have  a  little  apprehension  or 
guilt"  afterwards;  but  if  he  is  "discreet"  and  doesn't 
advertise"  his  foray,  he  may  very  well  find,  as  did  Adam 
and  Eve,  that  nothing  happens!  He  then  begins  to 
wonder  even  more:  perhaps  he  has  been  swindled — ^by 
his  parents,  by  society.  Perhaps,  as  we  were  fond  of 
saying  in  the  1920's,  morality  is  "the  bunk"  and  that 
by  observing  it  one  loses  out  on  all  manner  of  good  things. 

The  rest  of  the  story  follows  a  familiar  script.  Our 
hypothetical  youth  returns  to  the  wrong  end  of  life's 
teeter-totter  again  and  again,  and  eventually  decides  to 
remain  there  "in  his  heart"  but  to  deny  this  overtly.  Now 
the  "credit"  begins  to  pile  up  on  the  other  end.  And 
eventually  a  day  comes — perhaps  relatively  soon,  perhaps 
only  after  many  years — when  something  very  "mys- 
terious" happens:  the  teeter-totter  tips  into  the  position 
shown  by  the  dotted  lines;  and  we  say  of  our  young  (or 
now  perhaps  not-so-young)  friend  that  he  has  had  a 
nervous  "breakdown,"  that  he  has  lost  his  balance^ 
become  unstable. 

What,  now,  can  a  person  in  such  a  predicament  do  to 


232  The  Crisis  in  Psychiatry  and  Religion 

be  "saved"?  It  would  appear  that  two  equally  misleading 
answers  have  been  given  to  this  question  in  our  time. 
Protestant  theology  has  preached  a  doctrine  of  "justifica- 
tion by  faith."  Place  your  trust  in  God  and  believe  on 
Jesus  Christ,  we  have  been  urged,  and  your  sins  will  be 
immediately  forgiven.  And  for  those  who  prefer  a  "scien- 
tific" rather  than  a  "religious"  approach,  there  has  been 
the  doctrine  of  "justification  by  insight."  In  the  latter 
approach,  one  comes  to  see  that  his  sins  are  not  real  and 
that  he  doesn't  really  need  forgiveness.  It  is  hard  to 
determine  which  of  these  doctrines  has  been  the  more 
pernicious.  Bonhoeffer,  in  his  book  The  Cost  of  Disciple- 
ship  (1958),  has  eloquently  condemned  the  conventional 
Protestant  approach  to  personal  salvation  and  change  as 
a  doctrine  of  "cheap  grace" — and  hence  no  grace  at  all. 
And  although  psychoanalysis  can  hardly  be  accused  of 
being  "cheap"  in  the  monetary  sense,  its  great  appeal  has 
surely  likewise  arisen  from  the  assumption  that  one  could 
buy  his  way  out  of  perdition,  without  being  otherwise 
unduly  inconvenienced  or  anguished. 

For  those  who  are  now  disillusioned  regarding  both  of 
these  easy  ways  to  "salvation,"  it  is  beginning  to  appear 
that  "the  way"  is  indeed  hard  and  the  gate  narrow. 
Emotionally  disturbed  persons  have  not  talked  them- 
selves into  their  difficulties;  they  have  acted,  misbehaved; 
and  many  are  now  persuaded  that  one  likewise  cannot 
talk  (or  pray)  himself  out  of  them.  It  is  surely  unre- 
pented  and  unredeemed  evil  actions  that  destroy  our 
self-respect  and  moral  credit;  and  one  can  hardly  escape 
the  conclusion  that  these  cannot  be  recaptured  by  any 
means  other  than  compensating  good  actions  and  deeds 
[cf.  Chapter  12]. 

A  number  of  interesting  and  important  implications 
flow  from  this  way  of  viewing  sin  and  psychopathology. 
To  continue  with  the  same  physical  analogy,  it  follows 
that  just  as  one  does  not  immediately  become  neurotic 
upon  departing  from  virtue,  so  does  one  not  immediately 
become  "well"  by  "being  good"  for  a  little  while.  One 
has  to  work  at  it^  perhaps  for  a  very  considerable  time. 
But  just  as  conscience  eventually  condemns  and  turns 
against  ("attacks")  us  for  pursuing  an  evil  life  style,  so 
will  conscience  eventually  approve  and  reward  us  for  a 
better  type  of  conduct.  To  many  modern-minded  men 


i\  Theory  of  Psychopathology  233 

and  women,  traditional  religious  talk  about  the  wonders 
of  ''faith"  is  not  very  intelligible  or  convincing.  But,  in 
the  present  analogy,  we  nevertheless  see  the  relevance  of 
faith,  at  least  of  a  somewhat  different  kind.  Just  as  the 
fully  destructive  consequences  of  sin  are  not  immediately 
experienced,  neither  are  the  redemptive  consequences  of 
i^irtue  immediately  forthcoming;  and  one  has  to  have 
'aith,  confidence  that  redemption  will  eventually  come  if 
3ne  is  only  persevering.  Many  have  tried  to  have  faith 
in  conventional  religion  or  in  psychoanalysis  and  been 
jorely  disillusioned.  But  these  are  both  purportedly  easy 
"orms  of  redemption.  Genuine  deliverance  is,  by  contrast, 
arduous  but  never,  I  believe,  eludes  those  who  stead- 
"astly  pursue  it. 

But  what,  one  may  ask,  of  those  who  "never  had  a 
chance"?  In  illustrating  the  operation  of  the  teeter-totter 
principle,  we  deliberately  selected  an  individual  who  had 
been  born  to  and  reared  by  parents  who  were  themselves 
of  good  character,  loving  yet  firm.  But  psychoanalysis 
explicitly  teaches  that  neurotic  difficulties  arise  from 
an  excessively  strong  and  unrealistically  severe  superego 
which  is  created  by  the  hostility,  rejection,  and  moral 
irrealism  of  parents.  Hence,  every  neurotic  is  presumably 
a  person  who  "never  had  a  chance";  and  would-be  therapy 
all  too  often,  therefore,  takes  the  form  of  encouraging  the 
patient  to  wallow  in  self-pity  and  resentment,  thus  nur- 
turing the  paranoid  tendencies  which  are  already  present 
in  so  many  "sick"  individuals.  Is  it  any  wonder  that  the 
accomplishments  of  such  curative  strategies  are  not  im- 
pressive? 

Later  in  his  life  Freud  was  forced  to  admit  that  the 
supposed  correlation  between  neurosis  and  harsh  training 
in  childhood  could  not  be  empirically  confirmed.  He 
said:  "If  the  parents  have  really  ruled  with  a  rod  of  iron, 
we  easily  understand  the  child  developing  a  severe  super- 
ego, but,  contrary  to  our  expectations,  experience  shows 
that  the  superego  may  reflect  the  same  relentless  harsh- 
ness even  when  the  up-bringing  has  been  gentle  and 
kind"  (1933,  p.  90).  And  when  Freud  then  adds,  can- 
didly, that  he  has  not  "fully  understood"  this  paradox, 
we  see  how  shaky  is  the  whole  theoretical  and  therapeutic 
edifice  which  he  erected.  The  doctrine  of  what  might  be 
called  "justification"  by  "circumstances  over  which  one 


234  The  Crisis  in  Psychiatry  and  Religion 

has  no  control"  is  thus  pragmatically  questionable  and 
leaves  both  the  cause  and  cure  of  personality  disturbance 
completely  up  in  the  air  [see  Mowrer,  1961]. 

Also,  I  wish  to  call  attention  to  a  question  which  a 
student  raised  when  I  lectured  a  few  months  ago  at  a 
West  Coast  university.  He  said  he  wanted  to  know,  quite 
simply,  what  could  be  done  to  "save"  persons  who  are 
living  on  the  wrong  end  of  the  teeter-totter  but  who 
have  not  yet  broken  down,  fallen.  I  had  to  tell  him  that 
I,  frankly,  did  not  know.  It  is  clear  that  "salvation"  has 
two  aspects.  One  may  speak  of  saving  a  fallen,  manifestly 
sick  person  in  the  sense  of  helping  him  to  "rise  again";  or 
one  can  work  preventively,  to  try  to  "save"  people  in  the 
sense  of  sparing  them  the  anguish  of  an  acute  personality 
crisis.  But  most  of  the  efforts  which  we  psychologists 
have  directed  along  supposedly  hygienic  or  preventive 
lines  have  probably  been  as  misguided  as  our  more 
specifically  therapeutic,  or  redemptive,  efforts  have  been. 
The  leaders  of  Alcoholics  Anonymous  insist  that  an  alco- 
holic can't  be  "helped"  until  he  "hits  bottom";  and  it 
may  be  that  much  the  same  view  is  justified  with  respect 
to  other  types  of  "confirmed  sinners."  But  ideally  there 
ought  to  be  something  that  could  be  done  of  a  preventive 
nature.  This,  of  course,  is  the  age-old  problem  of  "evan- 
gelism"— the  hope  of  conversion  prior  to  crisis,  of  calling 
the  "hard-of-heart"  to  repentance  and  reformation  before 
it  is  "too  late."  Certainly  it  should  make  some  difference 
what  the  prevailing  ideology  of  a  society  is.  So  long  as 
we  continue  to  assume  that  there  is  no  relationship 
between  sin  and  psychopathology  and  that  if,  by  some 
mischance,  one  happens  to  crack  up,  one  can  always  hire 
an  expert  to  put  him  back  together  again,  wrong  living 
will  hardly  hold  the  implications  of  danger  (and  this  is 
an  important  part  of  what  makes  it  "wrong")  that  it 
ought  to  have.  But  the  repudiation  of  the  notion  of  such 
a  relationship  has  now  proceeded  so  far  that  it  is  very 
difficult  to  see  precisely  what  steps  can  be  taken  to  alter 
either  the  specific  modes  of  would-be  therapy  or  the 
general  tenor  of  what  passes  for  "mental  hygiene." 

In  passing,  it  may  be  noted  that  there  is  today  a  re- 
vival of  interest  on  the  part  of  religious  leaders  in  the 
concept  of  conversion,  but  with  an  attempt  to  avoid  the 
emotionalism  of  the  traditional  "revival"  meeting. 


Theory  of  Psychopathology  235 

iii.  what  happens  when  psychoanalysis 
IS  "successful"? 

A  variety  of  studies  (Ausubel,  1960;  Cartwright,  1959; 
Dollard,  1945;  Eysenck,  1952;  Masserman  &  Moreno, 
1959;  Ubell,  1958)  have  indicated  that  no  form  of 
secular  psychotherapy  which  has  been  around  long  enough 
and  practiced  by  a  sufficient  number  of  persons  to  have 
a  ''record"  can  boast  of  anything  very  substantial  in  the 
way  of  accomplishment  [see  also  Chapter  1].  When 
the  likelihood  of  spontaneous  remission  is  taken  into 
account,  the  accomplishment  is,  in  fact,  almost  exactly 
nil.  In  other  words,  untreated  controls  (to  the  extent 
that  such  controls  are  possible)  seem  to  fare  about  as 
well  as  treated  groups. 

All  this,  of  course,  is  well  known  in  professional  circles 
(e.g.,  see  Fromm-Reichmann  &  Moreno,  1956) — and  is 
gradually  leaking  through  to  the  public.  But  I  was  quite 
unprepared  to  have  an  analyst  tell  me,  a  few  years  ago, 
the  following  concerning  the  findings  of  the  psycho- 
analytic institute  of  which  he  was  a  member.  Typically, 
he  said,  he  and  his  colleagues  have  found  that  psycho- 
analysis has  one  of  two  outcomes:  either  the  analysis  is 
technically  unsuccessful,  which  means  that  it  fails  to 
lessen  the  presumed  over-severity  of  the  superego,  with 
the  result  that  the  patient  continues  to  be  neurotic;  or 
the  analysis  is  technically  successful,  i.e.,  the  superego 
is  softened-up  and  inner  conflicts  are  resolved,  but  the 
patient  then  develops  a  "character  disorder"  and  begins 
**acting  out." 

Manifestly  such  a  picture  is  not  reassuring  and  con- 
firms more  systematic  reports  of  negative  therapeutic  out- 
comes and  the  growing  popular  disillusionment.  But  it 
was  only  recently  that  the  theoretical  implications  of  the 
report  of  my  analyst  friend  dawned  upon  me.  More  than 
a  decade  ago,  I  began  suggesting  that  analytic  theory  is 
wrong  in  at  least  one  important  respect:  namely  in  its 
insistence  that  repression  goes  in  the  "direction"  of  the 
id,  rather  than  (as  I  had  come  increasingly  to  suspect) 
toward  the  superego.  And  if  this  surmise  is  sound,  it  has 
important  implications  for  the  theory  of  character  types. 

If,  as  Freud  insisted,  the  neurotic  is  a  person  with  an 


236  The  Crisis  in  Psychiatry  and  Religion 

excessively  severe,  over-developed  superego  or  conscience, 
the  three  major  character  types — criminal  psychopath, 
normal,  and  psychoneurotic — could  be  aligned  as  shown 
in  Fig.  2.  Such  an  arrangement  or  conceptualization  is 
neither  unreasonable  nor  unattractive,  in  some  v^^ays.  It 
permits  us,  for  example,  to  drav^  a  standard,  bell-shaped 
distribution  curve  over  these  three  personality  classifica- 
tions, v^ith  the  normal  type  of  personality  being  ''aver- 
age," model,  and  therefore  most  frequent,  and  v^ith  the 
two  deviant  forms  of  personality — psychopathy  and  psy- 
choneurosis — trailing  off  in  opposite  directions.  In  such  a 
frame  of  reference,  the  therapeutic  objective  is,  logically 
enough,  to  help  the  patient  move  away  from  his  position 
of  excessive  superego  severity,  in  the  direction  of  psy- 


Psychopath^^^"^  ^,      ,  ^"^^^Neurotic 


Fig.  2.  Character  typology  inherent  in  Freudian  psycho- 
analysis. Therapy  [broken  arrow)  in  this  system  consists,  logi- 
cally enough,  in  trying  to  get  the  neurotic  individual  to  "move'* 
in  the  direction  of  psychopathy  but  to  stop  in  the  region  of 
normality. 

chopathy,  but  to  stop  somewhere  in  between,  in  the 
general  area  of  normality  (see  short  broken  arrow).  This, 
of  course,  is  in  the  direction  opposite  to  that  in  which 
the  efforts  of  the  home,  church,  school,  and  other  socializ- 
ing (character-building)  institutions  are  largely  directed 
(see  long  solid  arrow).  And  so  it  was  that  psychoanalysis 
became  a  self-appointed  and  strident  critic  of  socializa- 
tion (cf.  Freud,  1930),  on  the  grounds  that  it  is  pre- 
cisely those  persons  in  whom  this  process  has  been  most 
effective  and  proceeded  furthest  that  neurosis  is  most 
likely  to  arise. 

If,  on  the  other  hand,  the  neurotic's  basic  difficulty  is 
not  that  his  superego  is  excessively  severe  but  that  the 
superego  has  itself  been  repudiated  and  ''repressed"  [cf. 
Chapter  2],  a  very  different  character  typology  results. 


A  Theory  of  Psychopathology  237 

as  schematically  portrayed  in  Fig.  3.  Here  the  neurotic, 
rather  than  being  seen  as  over-socialized,  over-controlled, 
over-inhibited,  falls  somewhere  in  between  the  criminal 
psychopath  or  sociopath,  on  the  one  hand,  and  the 
normal  type  of  person,  on  the  other.  Here  it  is  assumed 
that  such  a  person  has  an  essentially  normal,  basically 
adequate  superego  but  that  it  has  been  muted,  dis- 
regarded, dissociated.  This  constellation  or  arrangement 
of  character  types  might  at  first  seem  improbable,  in  that 
it  can  be  encompassed  ''statistically"  only  if  one  uses  a 
i  J-curve  of  the  kind  shown  in  the  figure.  To  some  this 
type  of  distribution  may  seen  anomalous;  but  the  work 


Psychopath. 


Fig.  3.  A  more  realistic  character  typology.  Here  it  becomes 
evident  why  a  form  of  "therapy"  which  pushes  the  neurotic 
individual  to  the  "left"  if  it  succeeds,  produces  a  psychopath 
rather  than  a  normal  person. 

of  F.  H.  Allport  (1934)  and  his  students  has  demon- 
strated, more  than  25  years  ago,  that  the  J-curve,  far 
from  being  anomalous,  is  typical  of  social  phenomena; 
and  since  character  is  manifestly  a  social  product,  we 
should  not  be  in  the  least  surprised  to  find  that  it  is  dis- 
tributed or  varies,  not  according  to  the  bell-shaped  curve, 
but  in  conformity  with  the  J-curve. 

Especially  significant  is  the  bearing  all  this  has  upon 
the  report  of  psychoanalytic  failures  and  ''successes"  cited 
at  the  outset  of  this  section.  If  the  conceptual  scheme 
shown  in  Fig.  3  is  valid,  then  a  form  of  "therapy"  which 
attempts  to  push  the  individual  toward  psychopathy 
would  be  expected  to  *'work"  in  precisely  the  way  re- 


238  The  Crisis  in  Psychiatry  and  Religion 

ported:  either  the  therapy  would  be  unsuccessful  and 
the  individual  would  continue  in  his  neurotic  state  oTy 
if  the  procedure  did  "move"  the  individual  character- 
ologically,  it  would  be  over  into  psychopathy,  not  nor- 
mality! 

A  few  weeks  before  writing  this  paper,  I  happened  to 
sketch  the  foregoing  considerations  to  a  clinical  psy- 
chologist who  has  long  been  in  private  practice  in  South- 
ern California — probably  the  most  thoroughly  analyzed 
area  in  the  world;  and  his  comment  was  that  he  could 
cite  innumerable  instances  both  of  clear  failure  of  psy- 
choanalysis and  of  its  negative  ''success,"  i.e.,  instances 
wherein  it  had  been  actively  countertherapeutic — and 
very  few  cases  in  which  it  had  had  a  genuinely  beneficial 
effect. 

As  Bakan  (1958)  points  out,  psychoanalysis  has,  how- 
ever, had  its  greatest  impact,  not  as  an  individual  therapy 
(great  as  that  has,  of  course,  been ) ,  but  as  a  broad  social 
ideology  and  personal  philosophy.  The  Stanford  sociolo- 
gist, Professor  Richard  LaPiere,  in  his  book  The  Freudian 
Ethic  (1959),  advances  cogent  and  numerous  reasons  for 
thinking  that,  as  a  social  ideology  and  philosophy,  analysis 
has  been  even  more  mischievous  than  as  an  individual 
"therapeutic"  procedure,  if  for  no  other  reason  than  that 
it  has  in  this  form  affected  so  many  more  persons. 


IV.   PARANOIA  AND   SOCIOPATHY 

If  one  adopts  the  view  that  neurosis  arises,  not  from 
personal  irresponsibility  and  immaturity  (see  Fig.  3), 
but  from  excessively  high  moral  standards  which  harsh 
and  unreasonable  parents  (and  other  socializers)  have 
drilled  and  dinned  into  the  individual  as  a  child  (see 
Fig.  2),  it  follows,  ineluctably,  that  the  individual  is  not 
"to  blame"  for  his  so-called  neurotic  difficulties.  It  is 
rather  his  father,  mother,  siblings,  teachers,  minister — 
anyone  but  himself.  And  soon  the  analysand,  under  this 
pernicious  tutelage,  is  luxuriating  in  self-pity  and  smol- 
dering resentment.  If  there  are  any  paranoid  trends  al- 
ready present,  how  else  could  they  be  more  effectively 
fanned  and  fed?  The  distinguishing  feature  of  the  para- 
noid is  that,  unlike  the  depressive,  he  typically  projects 


A  Theory  of  Psychopathology  239 

his  own  outraged  conscience  out  upon  others  and  then 
perceives  them  as  "after"  him,  and  against  him. 

Thus,  it  seems  reasonable  to  infer  that  psychoanalysis, 
in  its  classical  form  and  strategy,  would  drive  individuals 
toward  both  sociopathy  (psychopathy)  and  paranoia.  We 
have  already  seen  that  the  first  of  these  outcomes  does 
in  fact  occur.  In  ''successful"  individual  analysis  and  in 
the  movement  of  society  as  a  whole  which  has  been 
encouraged  by  the  "Freudian  Ethic,"  we  see  the  trend 
toward  the  "psychological  liberty"  which  we  first  thought 
was  going  to  be  our  salvation  but  which  we  are  now 
'beginning  to  view  instead  as  a  scourge.  While  in  South- 
ern California  I  repeatedly  heard  stories  from  clinical 
psychologists,  ministers,  and  social  workers  concerning 
the  youth  of  the  "best  families"  in  their  communities: 
'i.e.,  families  with  money,  education,  leisure,  and  exten- 
sive psychoanalytic  therapy.  And  what  was  the  picture? 
The  youth  of  such  families,  with  distressing  frequency, 
present  a  picture  of  demoralization:  little  personal  ambi- 
tion, self-centeredness  and  selfishness,  dope  addiction, 
general  defiance  and  insubordination,  illegitimate  babies, 
and  the  rest. 

The  situation  came  particularly  close  to  me  in  the 
following  incident.  At  the  home  of  one  of  my  friends,  I 
was  casually  watching  a  little  girl  (perhaps  four  years  old) 
and  her  mother  in  an  adjoining  yard.  The  child  was 
throwing  a  ball  for  a  kitten  to  chase  and  having  some 
difficulty  with  her  coordination.  Presently  she  made  a 
particularly  awkward  throw;  and  I  heard  her  say,  "Oh, 
God!  God  damn  it!"  as  casually  as  a  child  of  an  earlier 
generation  might  have  said,  "Oh,  my!"  or  possibly  "Drat 
it!"  Her  parents  have  very  likely  had  the  benefit  of  our 
best  schools  and  colleges;  and  if  they  have  not  personally 
"had  therapy,"  they  know  well  the  direction  in  which 
one  is  supposed  to  "move"  therein  and  how,  according 
to  therapeutic  doctrine,  to  bring  up  children  without 
neurotic  scruples  and  inhibitions.  The  difficulty  is  that 
we  thus  also  bring  them  up  without  character. 

Following  a  lecture  in  another  state,  a  middle-aged 
woman  tearfully  spoke  to  me  about  her  grown  son:  he  is 
now,  she  says,  himself  trained  as  a  social  worker  but  has 
been  "in  analysis"  for  several  years  and  still  is;  and  as  a 
part  0/  his  therapy  he  has  been  encouraged  to  blame  his 


240  The  Crisis  in  Psychiatry  and  Religion 

mother  for  all  his  difficulties,  has  little  or  nothing  to  do 
with  her,  and  seems  to  be  increasingly  paranoid  and 
hostile  in  his  general  outlook.  Recently  a  psychologist 
told  me  (I  unfortunately  have  misplaced  the  reference) 
of  a  factor-analytic  study  in  which  paranoid  and  socio- 
pathic  traits  come  out  as  a  single  factor.  This  is  hardly 
surprising,  since  both  types  of  individuals  perceive  their 
trouble  as  "out  there/'  as  indeed  it  is  for  the  sociopath; 
and  although  the  paranoid  individual  has,  more  than  the 
sociopath,  internalized  the  norms  of  the  culture,  he 
rejects  them  so  strenuously  that  he  can  experience  them 
only  in  projected  (delusional)  form.  How  astonishing 
that  we  should  have  adopted  as  ''therapy"  an  ideology 
and  interpersonal  strategy  which  we  are  now  beginning 
to  see  moves  us  away  from  the  more  benign  forms  of 
personality  disturbance  (depression,  anxiety  states,  etc.), 
not  toward  normality,  but  toward  the  two  most  malignant 
forms  of  personality  deviation  known  to  man!  ^ 

*Here  I  wish  also  to  comment  upon  a  question  which  is 
posed  by  the  undedying  logic  of  this  paper.  As  we  know,  the 
prospect  of  recovery  is  always  good  in  the  depressions  but,  at 
least  with  present  methods  of  treatment,  poor  in  schizophrenia. 
Why  should  this  be  the  case?  Many  contemporary  students  of 
the  problem  are  inclined  to  agree  that  depressions  are  pre- 
dominantly "psychological,"  i.e.,  involve  a  "working  through" 
of  personal  problems  but  assume,  because  of  its  greater  chron- 
icity,  that  schizophrenia  has  a  more  constitutional,  or  endog- 
enous, basis.  In  his  1936  book.  The  Exploration  of  the  Inner 
World,  Anton  Boisen  advanced  an  intriguing  hypothesis  which 
has,  I  feel,  received  too  little  consideration:  namely,  that 
schizophrenia  tends  to  be  chronic  and,  not  infrequently,  "pro- 
gressive" because  the  individual  manifesting  this  disorder  "re- 
fuses" to  admit  his  guilt  and  undergo  appropriate  remorse  or 
make  fitting  restitution.  Perhaps  sociopathy  and  schizophrenia 
are,  therefore,  presently  "untreatable"  for  much  the  same 
reason:  in  both  conditions  the  individual  does  not  take  respon- 
sibility for  his  antisocial  and  immoral  acts;  but  the  symptom- 
ology  is  different  because,  as  indicated  above,  the  sociopath 
(as  a  type)  has  no  conscience  whereas  the  schizophrenic  has 
one  but  projects  it.  The  depressive,  by  contrast,  "gets  well" 
because  he  has  a  conscience  and,  through  the  depression,  comes 
to  terms  with  it.  If  this  understanding  of  the  situation  is  vahd, 
it  might  lead  to  important  innovations  in  treatment:  notably, 
an  approach  which  would  help  the  schizophrenic  move,  not 
toward  sociopathy,  but  toward  the  depressive  syndrome. 


A  Theory  of  Psychopathology  241 

Elsewhere  (p.  163)  I  have  quoted  Schiller  to  the  effect 
that  "Life  may  not  be  the  highest  possession,  but  guilt  is 
the  greatest  evil."  Nietzsche's  ''Superman,"  we  recall,  was 
to  live  beyond  good  and  evil,  without  guilt;  and  Adolf 
Hitler,  World  War  II,  and  the  mass  extermination  of 
Jews  were  some  of  the  horrid  manifestations  of  this  dream. 
More  subtle  but  nonetheless  insidious  and  deadly,  the 
Freudian  Ethic  implies  the  same  philosophy  in  another 
guise.  And  it  is  no  accident,  surely,  that  it  has  prepared 
the  way  in  this  country  for  the  widespread  and  growing 
interest  in  Zen  Buddhism.  One  of  the  Chapters  in  Alan 
W.  Watts'  (1959)  book.  The  Way  of  Zen,  opens  with 
this  Zen  Buddhist  poem: 

The  perfect  Way  is  without  difficulty. 

Save  that  it  avoids  picking  and  choosing. 

Only  when  you  stop  liking  and  disliking 

Will  all  be  clearly  understood. 

A  split  hair's  difference. 

And  heaven  and  earth  are  set  apart! 

If  you  want  to  get  the  plain  truth. 

Be  not  concerned  with  right  and  wrong. 

The  conflict  between  right  and  wrong 

Is  the  sickness  of  the  mind. 

On  the  front  of  this  book  is  a  Buddha,  arms  folded, 
eyes  closed,  and  countenance  inscrutable.  How  different 
are  the  outspread  arms  and  open  countenance  of  Christ! 
Why  this  abandonment  of  the  Judeo-Christian  faith  for 
Nietzsche,  Freud,  and  Zen?  The  answer,  I  believe,  can 
only  be  found  in  certain  features  of  the  Protestant  Ref- 
ormation, especially  as  they  were  shaped  and  expressed 
by  John  Calvin.  His  doctrine  of  predestination  and  human 
helplessness  paved  the  way  for  the  despair  of  Kierkegaard 
and  the  anger  of  Nietzsche.  Roger  L.  Shinn  in  The  Exis- 
tentialist Posture  (1959)  credits  Nietzsche  with  saying 
that  "The  churches  are  the  tombs  of  God"  and  Kierke- 
gaard with  accusing  "the  churches  of  making  a  fool  of 
God"  (p.  70).  It  would  appear  that  some  revisions  in 
the  realm  of  theology  are  quite  as  urgently  needed,  if 
our  civilization  is  to  survive,  as  are  called  for  in  the  area 
of  secular  "therapy." 


Bibliography  and  Author  Index 

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indicate  the  pages  on  which  that  item  is  cited  in  the  text.  Non- 
specific reference  to  the  ideas  or  work  of  others  are  hkewise 
shown  in  brackets,  after  all  the  specific  references  have  been 
listed  or,  if  there  are  no  such  references,  directly  after  the  in- 
dividual's name. 

Abulafia,  A.  B.  S.  {See  Bakan,  1958a)  [113]. 

Adler,  A.  [21,  24,  227]. 

Allport,  F.  H.  (1934).  The  J-Curve  Hypothesis  of  Con- 
forming Behavior.  /.  Soc.  Psychol.,  Sy  141-183  [237]. 

American  Psychiatric  Association,  Committee  on  Rela- 
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Amer.  Psychiat.  Ass.  Mail  Pouch,  October  [50]. 

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Eysenck,  H.  J.  (1952) .  The  Effects  of  Psychotherapy:  An 
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Fagley,  R.  M.  (1960).  The  Population  Explosion  and 
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Foote,  N.  N.  &  Cottrell,  L.  S.,  Jr.  (1955).  Identity  and 
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Fromm-Reichmann,  Frieda  and  Moreno,  J.  L.,  Eds. 
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Fromm-Reichman,  Frieda  [229]. 

Galdston,  I.  (1955).  Ministry  and  Medicine  in  Human 
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Galileo  [111,  112,  122]. 

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Gallagher,  J.  J.  (1956).  Rejecting  Parents?  Exceptional 
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Gilkey,  L.  B.  (1960).  Calvin's  Religious  Thought.  Mo- 
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Hegel,  G.W.F.  [143]. 

Hepburn,  Katherine  [140]. 

Hitler,  A.  [241]. 

Hobbs,  N.  (1956).  Curing  Unreason  by  Reason:  A  re- 
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Hoch,  P.  and  Polatin,  P.  (1949).  Pseudoneurotic  Forms 
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Hollingshead,  A.  Redlich,  F.  (1958).  Social  Class  and 
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Jones,  E.  (1953-57).  The  Life  and  Work  of  Sigmund 
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Lifton,  W.  M.  (1953).  Counseling  and  the  Religious 
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1957)  [225].  —  [26,  223]. 

Muenzinger,  K.  [31]. 

Nebuchadnezzar,  King  [29] . 

Nestrov,J.  [121]. 

Niebuhr,  H.  R.  (1955).  Introduction  to  Alexander 
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Niebuhr,  H.  R.,  Williams,  D.  D.,  and  Gustafson,  J.  M. 
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Nietzsche,  F.  (1887).  The  Genealogy  of  Morals  (F. 
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Packard,  V.  (1957).  The  Hidden  Persuaders.  New  York: 
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Pauch,  W.  (1960).  The  Christian  Faith  and  Historical 
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Paul,  The  Apostle  [14,  109,  170,  186,  187-189,  220, 
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Pelikan,  J.  (1959).  Kiddle  of  Roman  Catholicism.  Nash- 
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Perkins,  Sara  E.  (1956).  My  4V2  Years  in  a  Chinese 
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Pfeutze,  P.  E.  (1954).  The  Social  Self.  New  York: 
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Pfister,  O.  (SeeBakan,  1958b)  [115]. 

Pike,  J.  A.  (1954).  Beyond  Anxiety.  New  York:  Charles 
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Pirandello,  L.  [179]. 

Progoff,   I.    (1956).   The  Death  and  Rebirth  of  Psy 

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Richards,  I.  A.  [149]. 

Riese,  W.  (See  Shoben,  1957)  [39]. 

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Russell,  Anna  [49,  53]. 

Schiller,  J.  C.  F.  [163-164,170]. 

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Schneiderman,  L.  (1954).  Anxiety  and  Social  Sensi- 
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Shakespeare,  W.  [88,  217,  226]. 

Shinn,  R.  L.  (1959).  The  Existentialist  Posture.  New 
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Shoben,  E.  J.,  Jr.  (1955).  Anxiety  vs.  Immaturity  in 
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Solomon,  H.  C.  (1958).  The  American  Psychiatric  As- 
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Stuber,  S.  I.  (1952).  The  Christian  Reader.  New  York: 
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Sullivan,  H.  S.  [150,229]. 

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Thompson,  F.  (1922).  The  Hound  of  Heaven.  Balti- 
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Troeltsch,  E.  (See  Niebuhr,  1960)  [184]. 

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[3]- 


Subject  Index 


Absolution,  doubtful,  106 

and  forgiveness,  195 
Abstractions,  Asiatic,  182 
Acceptance,  1 3,  78 
Accountability,  40,  5  3 

one-sided,  159 

social,  43 
Acting  out,  235 
Action,  vs.  insight,  46,  1 39 

prescription  for,   137,  221 

redemptive,  232 

in  sin  and  salvation,  78 
Action  Research,  176 
Affiliation,  social,  12 
Agitation,    following    confes- 
sion, 99,  104 
Alcoholics    Anonymous,    46, 

109,  140,  150,  233 
Altruism,  13 
Ambition,  106 
Anti-Semitism,  117 
Anxiety,  and  confession,  99, 
104 

and  estrangement,  148 

as  a  fever,  99,  104 

friend  or  foe,  33 

and  repression,  120 

theoryof,  68,  83,  148 
Apology,  202 
Asceticism,  9 

waning,  10 
Atonement,    a    bloody    doc- 
trine, 188 

outmoded,  199 

rituals  of,  102 

substitutionary,    147,    188, 
189 
Authority,    and   competence, 
51,  219 

lack  of,  218 

sacramental,  174 

Balance  sheet,  moral,  1 89 
Bankruptcy,  moral,  152 


Behavior  theory,  1 5 
Behaviorism,  4,  6,  15 

antiquated,  5 
Believers,  priesthood  of,  150 
Belongingness,  13 
Bible,  consistency  of,  188 
Blame,  and  neurosis,  49 
Breakdown,   nervous,    153, 

231 
Buchmanism,  109 

Calvinism,   indefensible,    183 
paradoxes  of,  159 
a  perversity,  1 60 
and  psychoanalysis,  1 60 
Catholicism,  and  absolution, 
150 
a  challenge  to,  208 
and  mental  health,  107 
metaphysical  claims  of, 

204 
paradoxes  of,  204,  206 
and  science,  111 
and  works,  189 
Catholics,  mental  health  of, 

194,  204 
Character,    and    community, 
214  ff. 
and  guilt,  213 
and  neurosis,  43 
strength  of,  215,  230 
typology,  236 
Character  disorder,  235 
Charity,  13 

commercialized,  166 
and  personal  change,  219 
secret,  198 
Chastisement,   redemptive, 

219 
Cheap  grace,  190,232 
Chemotherapy,    13,   44,    51, 

59 
Christianity,  and  Judaism, 
112 


254 


UBjECT  Index 

a  minority  movement,  172 

uniqueness  of,   182 

hurch,  and  state,  166 

hurches,  a  challenge  to,  60, 
169 

default  of,  59 

and  mental  disease,  61,  162 

openness  of,  71 

reformation  of,  172 

lergymen,  competence  of, 
171 

inconsistency  of,  157,  186 

as  professors,  174 

psychoanalyzed,  160 

linical     movement,     deflec- 
tion of,  64 

linical   training,   for  clergy- 
men, 62  ff. 

limitations  of,  73 

ommunication,  83 

ommunity,  180 

achievement  of,    147,   191 

and  character,  214  flf. 

of  sinners,  191 

ompetence,  interpersonal, 
12 

ompulsion,  226 

onfession,  43,  91  ff.,  180 

and  absolution,  99 

and  action,  78,  102 

and  agitation,  99 

and  atonement,  101 

Catholic,  109,  201  ff.,  227 

and  community,  147,  214 

of  crime,  99 

defects  of,  194 

as  a  deterrent,  195 

directly  to  God,  202,  216 

and  honesty,  215 

to  laymen,  107,  195 

vs.  insight,  107 

insufficient,  94,  104,  202 

motivation  for,  75 

objections  to,  190,  193 

officially  sanctioned,  190 

and  openness,  109 

in  Protestant  Churches, 
193 

or  psychoanalysis,  192 

reconsidered,  192 

and  recovery,  220 

relief  from,  95 

and  restitution,  55,  83 

return  to,  137,  189  ff. 


255 

as  a  sacrament,  201 

in  the  sects,  140 

therapeutic,   92,   193, 
201  ff. 

three  steps  in,  191 

value  of,  175 

well  received,  98 

why  necessary,  202 

without  recovery,  98 
Confidence,  need  for,  233 
Confinement,  and  expiation, 

100 
Conflict,    in    Catholic    posi- 
tion,  207 

constructive  aspects,  25 

ethical,  146 

between  Freud  and  Moses, 
114 

moral,  214 

in  psychopathology,  1 54 

in  religion,  66 

and  repression,  20 

resolutions  of,  144 

of  science  and  religion,  183 

in  the  seminaries,  63 

in  therapeutic  relationship, 
95 
Conformity,  paradox  of,  130, 

144 
Conscience,  approval  by,  33, 
216,232 

clear,  188 

combatting,  114 

compared  with  court,  100 

diseases  of,  22,  37,  68 

distrust  of,  37 

externalization  of,  32,  240 

and  eyes,  94 

fairness  of,  196 

morbid,  64 

and  neurosis,  31 

outbreak  of,  153 

outraged,  126,  239 

and  paranoia,  239 

as  prattler,  67 

projected,  32,  240 

protests  of,  25 

and  recovery,  64,  240 

rejection  of,  84,  240 

repression  of,  29,  68,  127, 
206 

and  rigidity,  5  5 

and  the  unconscious,  17 

value  of,  162 


256 

variations  in,  27 
vengeance  of,  23 
as  voice  of  God,  32 
Conscientiousness,  false,  223 
Constitution     (see    C)rganic- 

ism) 
Consumption,  conspicuous, 

146 
Conversion,  57,  234 
Counseling,  as  confession,  78, 
137,190 
and  psychotherapy,  33, 
107  ff. 
Courage,  31 

Creativity,  vs.  conformity, 
144 
myth  of,  143 
Credit,  moral,  231 
Crime,  and  punishment,  100 

and  retribution,  1 68 
Criminals,    rehabilitation    of, 

102 
Crisis,  institutional,  1 38 

moral,  151 
Culture,  disunity  of,  143 

Demoralization,  social  and 

personal,  239 
Depersonalization,  216 
Depression,  and  guilt,  91,  97 

vs.  paranoia,  240 

self -limiting,  100 
Despair,  Christian,  160 

and  the  devil,  117 
Determinism,  58 

psychic,  159 
Deviance,  open,  153 
Devil,  as  cure  for  depression, 
116 

Freud  identified  with,  114- 
116 

and  the  id,  122 

powers  of,  118 

as  principle  of  evil,  119 

as  a  projection,  125 

and  psychopathology,  80, 
114 

as  suspended  superego, 
117,125 

as  tempter,  117 
Diagnosis,  differential,  224 
Dick  Tracy  Theory,  86  ff. 

objections  to,  88 


Subject  Index 

Discipline,  and  normality,  42 

penitential,  192 
Disgrace,  and  disease,  82 
Disillusionment,  235 
Disobedience,  with  integrity, 

145 
Dissociation,  165 
Drug  Therapy   {see  Chemo- 

therapy ) 
Duplicity,  destructive,  146 

Economy,  expanding,  146 

Education,  public,  166 

Ego    psychology,    31  E,    34, 

45,  228 
Ego  strength,  34,  36 
Electrotherapy,  111 
Embezzlement,  152 
Emotionality,  excessive,  226 
Encounter,  179 
Equilibrium,  moral,  231  (see 

also  Balance  sheet) 
Estrangement,  131 
Ethics,  and  psychopathology, 
130 
and  society,  146 
Evangelism,  234 
Evidence,  canons  of,  171 
Evil,  and  bondage,  31 
corporate,  122,  146 
personal  and  secret,  147 
problem  of,  142  ff. 
Evolution,  evidence  for,  14 
and  psychoanalysis,  1 5 
and  psychology,  4  ff. 
theory  of,  1 
Existence,  meaning  of,  52 

moral  basis  of,  5  3 
Existential  Analysis,  1 80 
Existentialism,   52,   177  ff., 

184,  185,  241 
Ex-patients,  as  therapists,  218 
Experience,  denial  of,  164 
Expiation,  97  ff. 
Extroversion,  225 
Eyes,   as   conscience  symbol, 
94 

Faith,  reinterpreted,  233 

and  works,  221 

without  works,  187 
Father,  corruption  of,  96 
Fear,  and  authority,  213 

in  schizophrenia,  86 

of  sex,  213 


iuBjECT  Index 

^ees,  and  self-punishment, 
141 

i'ellowship,  13 
"orgiveness,  25 

not  accepted,  197 

too  easy,  188 

over-worked,  188 

and  prayer,  214 

presumption  of,  196 

and  psychoanalysis,  175 

questionable,  195,  196 
;   traffic  in,  106,  110,  138 
.^'raudulence,  personal,  150 
^'ree  association,  101 
"reedom,  and  alienation,  52 

loss  of,  31 
F'reud,  and  depression,  117 

as  the  devil,  116,  132 

his  mission,  131 

as  Moses  killer,  115 
^'reudian  Ethic,  241 
E^'reudianism,  131,  165 
F'unctionahsm,  4,  6,  8,  1 5 
F'undamentalism,  61,  165 

l^lory,  lost,  173 

I^od,  conceptions  of,  37,  114 

and  conscience,  29,  37,  59, 
67 

faith  in,  37 

flight  from,  155 

grace  of,  159 

hand  of,  30 

inscrutability  of,  160 

of  justice,  59 

as  love,  59 

love  of,  219 

manifestations    of,    79-80, 
123 

as  person,  182 

and  psychopathology,  79 

short-cut  to,  106,  216 

and  sin,  185-187 

and  the  unconscious,  128 

unpredictable  favor  of,  159 

wrath  of,  28  ff.,  79-80,  188, 
219 
Good  Works,  condemned, 
158 

among  Mormons,  209 

objections  to,  198 

and  redemption,  232 
Grace,  costly,  108 

debased,  149 


257 

and  disgrace,  1 89 
the  gift  of  God,  186 
inadequate,  100,  108,  189 
over-emphasis      on,       106 

(see  also  Cheap  Grace) 
Group  dynamics,  177 
Group  practice,  by  clergymen, 

_  218 
Guilt,  analysis  of,  32 
attitudes  toward,  57 
barrier  to  marriage,  210 
a  central  problem,  167 
and  confession,  91  ff. 
conscious    or    unconscious, 

148 
constructive,  25,  64 
definition  of,  81,   130, 

142  ff. 
displaced,  82,  227 
and  divine  grace,  175,  181 
as  an  evil,  164 
excessive,  75 
false,  175,200,213 
feeling  or  fact,  105 
vs.  guilt  feelings,   56,   104 
harmful,  66 

historically  considered,  105 
imaginary,  81 
and  incest,  209 
legal,  167 
masks  of,  59 
mismanagement  of,  59 
as  motivation,  199 
and  neurosis,  126,  213 
in  psychoanalytic  theory, 

82 
and  psychopathology,  217 
reaction  to,  54 
real  or  false,   56,   68,   81, 

89,  142,  190 
reality   of,    83,    213,    217, 

230 
beyond  religion,  190 
and  self-loathing,  223 
and  social  reality,  223 
and  the  state,  167 
and  superman,  241 
not  taken  seriously,  128 
taken  seriously,  108,  109 
unatoned,  131 
unresolved,  200 

Hallucination,  and  con- 
science, 94 


258 


Subject  Indei 


Healing,  through  confession, 

or  confession,  107 

202 

and  neurosis,  41,  78 

Hell,  eliminated,  59 

vs.  repentance,  100 

and  neurosis,  48 

not  sufficient,  197 

in  religious  thought,  61 

Insurance,  and  charity,  166  ] 

as  state  of  mind,  42 

Integration,  215 

Helplessness,  of  man,  241 

into  society,  215 

in  sin,  241 

Integrity,  217 

Holy  Spirit,  basis   of  all  re- 

and ego  strength,  146 

ligion,  124 

and  personal  identity. 

and  emotional  disturbance, 

177  ff. 

154 

value  of,  216 

and  a  new  synthesis,  131 

Introversion,  225 

and  reformation,  173 

Inventiveness,  social,  176 

significance  of,  123  ff. 

Investment,  personal,  1 39 

and  the  unconscious. 

Irresponsibility,  238 

125  ff. 

religious   and  psychoanaly] 

Honesty,  contempt  for,   146 

tic,  160 

and    mental    health,    145, 

Isolation,  personal,  25 

215 

social,  92 

Hospitalization,  157 

and  temptation,  147 

after  confession,  99 

Issues,  vs.  troubles,  135, 

Ul 

by  religious  groups,  218 

Hospitals,  church  directed,  79 

Jealousy,  36 

failure  of,  76 

Jesus  Christ,  as  person. 

18* 

inadequate,  167 

revelation  in,  182 

as  mission  field,  79 

Judaism,  112 

under-churched,  79 

Judgment,  moral,  40 

Hostility,  fear  of,  83 

and  suffering,  56  ff. 

Hypnotism,  111 

Justification,    by   faith. 

158 

Hypocrisy,  152,202 

232 
by  insight,  232 

Id,  and  the  devil,  122 

in  Protestant  doctrine, 

17. 

Identity,  denial  of,  217 

and  integrity,  177  ff. 

loss  of,  52 

and  neuroticism,  216 

quest  for,  135 
Ideology,  234 
Illness,  defended,  203  ff. 
Immaturity,  238 
Impulse,    repression    of,    36, 

160 
Incest,  209 

and  insanity,  147 

and  psychopathology,  96 
Indulgence,  105 
Inhibition,  and  character, 

237 
Injustice,  161 

and  psychopathology,  161 
Insanity,  and  character,   230 

and  isolation,  148 
Insight,  vs.  action,  1 39 


Kabbala,  112ff. 
Knowledge,  tree  of,  121 

Latter-Day  Saints,  208 

salvation  in,  212 
Laws,  universal,  183 
Learning  theory,  31 
Liberation,  emotional,  67 
Life,  abundant,  10 
Life  style,  changes  in,  153 
Lost  sheep,  169,  171,  173 
Love,  and  charity,  57 

of  God,  154 

and  relatedness,  148 

Man,  and  community,  155 
cultivated,  179 
disillusioned,  175 
fall  of,  120 
helplessness  of,  159, 165 


|UBjECT  Index 

nature  of,  35,  54,  153,  178, 
179 

predicament  of,  175 

science  of,  180 

self-domesticated,  38 

a  social  creature,  131 
/lartyrdom,  106 
Masochism,  141,  199 
/laterialism,  8 
/laturity,  and  religion,  71 
/ledicine,  aggrandisement  of, 
50 

and  morality,  58 

and  psychology,  50 

and  suffering,  58 
v/[editation,  113 
viemory,  and  illusion,  178 
viental  Hygiene,  and  mo- 
rality, 9  ff. 
viental  illness,  a  questionable 

concept,  51 
Viesmerism,  70 
Vlind,  and  adaptation,  1 

survival  of,  16 

theories  of,  5 
Vlind-body  problem,  2  ff. 
Vlissions,  foreign  or  do- 
mestic, 78 
Vlistakes,  correction  of,   151 
Mobihty,  downward,  153 
Morality,  227 

apathy  toward,  58 

and   psychopathology,    23, 
58,  197 

and  skepticism,  41 
VIoses,  attacked  by  Freud, 
114 

the  lawgiver,  115 

ursurped  by  Freud,  115 
Mystery,  religious,  187 
Mysticism,  185 

and  chaos,  182 

and  psychoanalysis,  113 


f^aturalism,  and  the  Bible,  30 
Natural  law,  125 
Needs,  psychological,  16 
Negativism,  moral,  181 
Nemesis,  200 
Neo-Freudianism,  161  ff. 
Neo -orthodoxy,  184 
Neurosis,  cause  of,  226 
and  character,  43 


259 

and  childhood  training, 

233 
and  estrangement,  25,  169 
as  illness,  50 
two  kinds,  223 
and   morality,    8,    24,   44, 

238 
nature  of,  26  ff.,  54 
presenting  symptoms  of, 

226 
and  responsibility,  48 
and  retribution,  200 
so-called  rigidity  in,  31 
and  sin,  48 
and  socialization,  34 
theory  of,  1 5 
Neurotics,  held  blameless, 

160 
no  interest  in,  110 
life  history  of,  84 
Nihilism,  intellectual,  181 

moral,  241 
Nonconformity,  constructive, 

145 
Normality,  236 
conditions  of,  34 
and  rectitude,  151 
and  values,  34 

Objectivism,  5 

Openness,  and  integrity,  145 
Organicism,  44,  240 
Oxford  Group,  35,  109 

Paranoia,  151 

vs.  depression,  240 
encouragement  of,  233, 

238 
immutabihty  of,  101 
and  resentment,  101 
and  sociopathy,  240 

Parapathy,  23 

Parents,  and  conscience,  59 
influence  of,  233,  238 

Penance,  195,  197 

Performance,  level  of,  224 

Persecution,  ideas  of,  98 

Personality,  types  of,  236 

Persons,  or  principles,  180  ff. 

Personology,  177 

Perversion,     and     depression, 
97 

Phenomenology.  179 

Philanthropy,  219 


260 

Philosophy,    and    counseHng, 

Iff. 
Phrenology,  70 
Positivism,  5 

Possession,  and  neurosis,  116 
Prayer,  or  action,  221 

use  of,  220 
Preaching,  and  guilt,  75 
Predestination,  109,  187,  241 
Pretense,  and  guilt,  147 
Pride,  sin  of,  187,  198,  220 
Principle,  return  to,  185 
Principles,  universal,  182 
Private  practice,  77 
Promiscuity,  and  guilt,  98 
Protection,  legal,  218 
Protestant   Reformation,    39, 
241 

ambiguities  of,  176 

incomplete,  110 

and  psychotherapy,  105, 
156 

rejection  of  confession,  106 
Protestantism,  and  ambition, 
106 

and   guilt,   77,    106,    157, 
214 

highly  intellectual,  174 

paradoxes  of,  107,  164 

and  psychoanalysis,  160, 
175,  190 

and  science,  112 

twilight  of,  174 
Psychiatry,  ambiguities  of, 
200 

changes  in,  90 

competence  of,  161 

interpersonal  emphasis,  229 

the  new  faith,  67 

of  Old  Testament,  29 

and  religion,  28 
Psychoanalysis,  1 

advances  in,  45,  161,  228 

alternative  views,  20  ff. 

blandishments  of,  83 

a  big  business,  149 

and  Christianity,  127 

vs.  confession,  203 

not  confirmed,  54 

cost  of,  140 

criticisms  from,  236 

defectors  from,  227 

demise  of,  22 

demoralizing,  239 


Subject  Inde 

and  the  devil,  114 
disillusionment  regarding, 

15 
disintegration  of,  123,  22 
paralyzing  effect  of,  133 
as  a  new  ethic,   133,  23 
fallacies  of,  54 
history  of,  1 10  ff . 
and  humility,  69 
impact  on  clergymen,  73 
impact  in  religion,  60, 

65  ff.,  134 
inception  of,  82 
inconsistent,  233 
and  Kabbalism,  113  ff. 
and  medical  science,  49 
nontherapeutic,  161,  162 
permissiveness  of,  228 
not  for  poor,  149 
premature  acceptance  of, 

50 
presumptions  of,  17 
a  pseudo-science,  176 
re-appraisal  of,  60,  68 
and  religion,  111,  159  ff. 
vs.  religion,  69,  112 
vs.  religious  therapy,  24  ff 
resistance  to,  165 
results  of,  121,  133,  159 

235,237,238 
as  science,  70 
self-centered,  220 
and  sociopathy,  2  37 
spoofing  of,  5  3 
therapeutic  strategy  of,  82 
as  surgery,  38 
as  therapy,  63,  175 
as  way  of  life,  114 
weaknesses  of,  1 32,  222  ff. 
Psychoanalyst,  omniscience 

of,  17,  121 
as  tempter,  118 
worry-free,  141 
Psychologists,  and  psycho- 
analysis, 50 
Psychology,  academic,  1 
attraction  of,  149 
and  biology,  4  ff. 
crisis  in,  2 
and  evolution,  1 5 
and  moral  competence,  9 
and  theology,  52 
Psychopathology,  attitudes 

toward,  66 


Subject  Index 

and  conduct,  84 

and  duplicity,  146 

history  of,  28,  103  ff. 

and  ideology,  51 

among  monastics,  203 

moral  basis  of,   61,  91, 
103,  190 

nature  of,  18,  81  ff. 

needed  research,  84 

prevalence  of,  7,  157,  208 

redemptive,  219 

re-interpreted,  83 

religious  rejection  of,  205 

without  repression,  29 

and  sin,  234 

social  basis  of,  17,  90 

and  social  values,  1 6 

susceptibility  to,  163 

theory  of,  151 

value  of,  58 
Psychopathy,  38,  235 

(see  also  Sociopathy) 
Psychosis,  as  disease,  203 

hazards  of,  78 

a  state  of  sin,  148 
Psychotherapy,      accomplish- 
ments of,  235 

as  a  business,  77 

chent-centered,  164 

and  cultural  change,  115 

in  disarray,  3 

goals  of,  237 

as  guide  to  morality,  67 

limitations  of,  140,  213 

nontherapeutic,  17,  101, 
138 

reform  of,  72 

re-orientation  of,  105,  240 

and  seduction,  93 

talk  or  action,  101 

and  values,  103  ff. 
Punishment,  need  for,  199 

role  in  therapy,  56-57 

of  sinners,  5  3 

value  of,  39 

Real  guilt,  not  recognized, 

224 
Reality  testing,  231 
Reconcilliation,  of  science 

and  religion,  184-185 
Recovery,  and  personal 

change,  55 
from  psychopathology,  240 


261 

or  reformation,  153 

and  self -blame,  101 
Redemption,  148  ff. 

not  easy,  149 

not  for  sale,  149 

and  recovery,  55 

and  reform,  141 
Referral,  45 

to  other  clergymen,  218 

dubious,  224 

to  psychiatrists,  169 

rationale  of,  74 
Reformation,  9 

contemporary,  15,  105 

incomplete,  171  ff. 

must  continue,  172,  176 

a  permanent  movement, 
172 

value  of,  166 
Rejection,  ambiguity  of,  9  3 

of  seductiveness,  95 
Relatedness,  rupture  of,  90 
Relationship,  180 

interpersonal,  12  ff. 
Release  therapy,  125 
Religion,  abdication  of,   167 

and  action,  182 

authenticity  of,  62,  169 

clinical  interest  of,  61 

two  dimensions  of,  110 

in  disrepute,  122,  168 

great  potential  of,  76 

impotence  of,  112,  157 

inadequacy  of,  168,  197 

and  medicine,  62 

and  mental  health,  11,  32, 
52 

and  mental  hygiene,  3 

predicament  of,  60,  69 

priestly  or  prophetic,  140 

prostration  of,  1 36 

and  psychoanalysis,  52, 
111,  159 

as  psychology,  1 0 

as  psychopathology,  10,  63 

return  to,   135 

revitalization  of,   80,    136, 
168 

and  science,  14,  66  ff.,  82 

scorned  by  Freud,  159 

shame  of,  111 

subordination  of,  76 

and  theology,  220 

therapeutic,  212 


262 

and  the  unconscious,  28 

vitality  of,  1 1 

weakness  of,  110 
Religiosity,  increasing,  123 
Remission,  spontaneous,  235 
Remorse,  repression  of,  68 
Repentance,  100 

call  to,  30 

and  change,  234 
Repression,  18  ff. 

direction  of,  26  ff.,  35,  126, 
235 

dynamics  of,  19 

vs.  ego  controls,  36 

elusive,  84 

failure  of,  8  3 

Freudian,  26,  36 

and  guilt,  26 

theory  of,  127 

and  the  unconscious,  19  ff. 
Research,  limitations  of,  176 

need  for,  81 
Resentment,  238 
Resiliency,  151 
Resistance,  nonviolent,  145 
Resolution,   and  redemption, 

105 
Responsibility,   abandonment 
of,  240 

and  forgiveness,  196 

moral,  43,  56 

and  neurosis,  31,  48 

rejection  of,  58 
Restraint,  and  recovery,  38 
Restitution,  152,  240 

or  retribution,  168 
Resymbolization,  173 
Retribution,  167,  200 

vs.  restitution,  102 
Revelation,  divine,  125 
Revolution,    cultural    and 
moral,   131 

psychiatric,   132 
Righteousness,   self-pro- 
claimed,  109 
Rigidity,  neurotic,  55 


Sacrifice,  misinterpreted,  189 

and  recovery,  219 
Salvation,  by  grace,  186 

by  psychoanalysis,  182 

not  for  sale,  140 

a  social  operation,  221 


Subject  Index 

spurious,  232 

theories  of,  109 

two  kinds,  2  34 

uncertainty  of,  1 60 
Salvation  Army,  135,  140, 

150 
Sanity,  and  humanity,  38 
Satan,  119 

Schizophrenia,   and  criminal- 
ity, 89 

Dick  Tracy  Theory  of,  86 

diverse  opinions  of,  87 

and  fear,  86 

as  interpersonal  disorder, 
126 

and  isolation,  92 

loss  of  self-esteem  in,  87 

malignancy  of,  101 

and  possession,  116 

and  pretense,  87 

as  progressive  terror,  104 

and  secrecy,  87 

and  sexual  deviation,  90 

a  social  disease,  89 

theory  of,  84,  85  ff. 
Schizophrenics,   basically   de- 
cent, 89 

indifference  of,  87 

pseudoneurotic,  90 
Science,  and  religion,  125, 

176,  184-185 
Scientism,  58 
Scrupulosity,  65,  206,  226 
Secrecy,    and    ego    weakness, 
215 

and  shame,  148 
Secularization,  of  various 

functions,    166  ff. 
Seductiveness,  of  client,  93 

as  defense,  95 
Self,  as  social   phenomenon, 

13 
Self-acceptance,  162 

and  sociopathy,  163 
Self-condemnation,  219 

capacity  for,  161,  227 

in  psychopathology,  161 
Self -contempt,  163 
Self-disclosure,  83,  108 
Self-examination,  178 
Self-interest,  217 
Self-knowledge,  178 

through  confession,  192 

vs.  self-revelation,  180 


Subject  Index 

Self-pity,  238 

in  psychotherapy,  1 64 
Self-punishment,    construc- 
tive, 66 

in  depression,  100 

disapproval  of,  163 

unjustified,  161 
Self-rejection,  211 
Self-respect,  recovery  of,  202 
Self-revelation,  cpst  of,  190 
Self -revulsion,  151 
Seminaries,  uneasiness  in,  73 
Service,  as  sacrifice,  199 
Sex,  and  neurosis,  23 

and  social  adjustment, 
214  ff. 
Sexuality,  acceptance  of,  75 

fearof,  83,  213 

repressed,  119 
Shame,  and  salvation,  55 
Sickness,  concept  of,  39 

over-extension  of,  168 

and  pessimism,  40 

or  salvation,  153 

vs.  sin,  75 

a  stultifying  concept,  138, 
142 
Significant  others,  108 
Sin,  acceptance  of,  54 

act  or  attitude,  186,  188 

and  atonement,  188 

definition  of,  42 

and  delusion,  98 

and  depersonalization,  185 

destroys  community,  191 

and  expiation,  199 

forgiveness  of,  232 

helplessness  in,  165 

and  mental  sickness,  205 

objections  to,  41 

original,  147 

and  psychopath ology,  148, 
232 

due     to     psychopathology, 
205,  211 

and  punishment,   53 

and  redemption,  51 

re-evaluated,  40 

repression  of,  160 

and  secrecy,  148,  216 

and  self-hatred,  54 

vs.  sickness,  43,  50,  67,  82 

or  sickness,  87,  91,  229 

and  sins,  185  ff. 


263 

and  sociopathy,  43 

and  suffering,  43,  48 

as  therapy,  205 

unpardonable,  66,  98 

and  worldly  hell,  42 
Sincerity,  violation  of,  86 
Sinners,  confirmed,  234 
Social  act,  140 
Sociality,  2,  220 

betrayal  of,  131,  155 

loss  of,  86  ff.,  90 

man's  inveterate,  153 

restored,  202 
Socialization,  225,  230,  233 

and  neurosis,  48 

opposition  to,  236 
Society,  basic  premises  of,  147 

debt  to,  100 

nature  of,  38 

presupposes  conscience, 
162 

and  religion,  173 
Sociology,  and  self-theory,  13 
Sociopathy,  27 

and  paranoia,  239 

(see  also  Psychopathy) 
Souls,  the  cure  of,  192 
Spiritual  directors,  194 
Strength,  personal,  198  ff. 
Suffering,  misinterpreted,  58 

in  psychopathology,  56  ff. 

redemptive,  58 
Suicide,  151 

and  Catholicism,  107,  194 
Superego,    harshness    of,    54, 
66,  114 

as  introjected  parents,  161 

irrational,  32 

and  Mosaic  law,  115 

a  negative  agency,  127 

power  of,  223 

repression  of,  236 

severity  of,  233,  235 

tyrannical,  158,  225 
Survival,   psychological,   6  ff., 
16 

question  of,  1 39 
Symptoms,  and  anxiety,  26 
Synthesis,  of  psychology  and 
religion,  103 

Talion,  200 
Taoism,  181 
Testimony,  14 


264 

Theologians,  compromised, 
175 

on  sin,  170 
Theology,    and    ethical    con- 
cern,  184 

language  of,  143 

misleading,  222,  232 

pastoral,  74 

perilous  and  arrogant,  175 

primacy  of,  220 

and  psychology,   176,  222 

recovery  of,  171 

undisciplined,  171 

vagaries  of,  170,  173 

vogues  in,  170-171 
Therapist,  as  father,  96 
Therapists,  secular,  224 
Therapy,  and  action,  46 

aim  of,  30,  224 

nature  of,  35,  38 

as  personal  growth,  34 

to  undo  repression,  20 

as  transference,  25 
Total  depravity,  189 
Transference,  113 
Treatment,  ambiguities  of, 
101 

humane,  56 

as  instruction,  44 

medical,  50 

as  redemption,  45 

symptomatic,  153 

and  temptation,  120 
Troubles,  vs.  issues,  135,  138 


Subject 

Typology,  character,  2 
Freudian,  236 

Unconscious,  benevole 
conception  of,  17  ff. 
content  of,  27 
diabolical,  128 
Freud's  theory  of,  1 
and  Holy  Spirit,  12 
neurological  basis  ol 
re-examined,  28  ff.,  ; 
and  repression,  19  ffJ 
vs.  the  unuttered,  1^ 
Uncovering,  vs.  coverii 
Understanding,  41 
Unreahty,  sense  of,  21 

Values,  contempt  for, 

moral,  143 

nev^^  interest  in,  52 
Verification,  of  religioi 

claims,  207 
Virtue,  and  freedom. 


Will  power,  source  ol 

228 
Wisdom,  secret,  113 
Working  through,  in  t 

sion,  240 
Wrath,  of  God,  154,  2 

You,  the  real  you,  178 

Zen  Buddhism,  181,  2" 


4  22  16 


^ 


Date  Due 


Due 

Returned 

Due 

Returned 

APR  Q  ]  i 

i  NOV  2  2  1988 

-  'v  •J' 

The  crisis  in  psychiatry  and  r  main 
131.322M936cC.2 


3  ISbS  032Tt  bDSa 


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